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LONG-TERM ADHERENCE...
LONG-TERM ADHERENCE TO FLECAINIDE AS A RHYTHM CONTROL THERAPY IN RECURRENT ATRIAL FIBRILLATION - A RETROSPECTIVE COHORT STUDY
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- Siotis, Alexander (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Madsen Hardig, Bjarne (författare)
- Lund University,Lunds universitet,Kardiologi,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Kliniska Vetenskaper, Helsingborg,Institutionen för kliniska vetenskaper, Lund,Cardiology,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine,Clinical Sciences, Helsingborg,Department of Clinical Sciences, Lund
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Johansson, Samuel (författare)
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- Carlson, Jonas (författare)
- Lund University,Lunds universitet,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Lund University Research Groups
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- Wagner, Henrik (författare)
- Lund University,Lunds universitet,Kliniska Vetenskaper, Helsingborg,Sektion II,Institutionen för kliniska vetenskaper, Lund,Medicinska fakulteten,Clinical Sciences, Helsingborg,Section II,Department of Clinical Sciences, Lund,Faculty of Medicine
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- Platonov, P.G. (författare)
- Lund University,Lunds universitet,Electrocardiology Research Group - CIEL,Forskargrupper vid Lunds universitet,Lund University Research Groups
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(creator_code:org_t)
- Elsevier BV, 2022
- 2022
- Engelska.
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Ingår i: Heart Rhythm. - : Elsevier BV. - 1556-3871 .- 1547-5271. ; 19:5, s. 315-316
- Relaterad länk:
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http://dx.doi.org/10...
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https://lup.lub.lu.s...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- Background: The choice of rhythm control drugs for recurrent atrial fibrillation (AF) remains empirical and is based on the safety profile rather than predicted efficacy. Flecainide is recommended for prevention of AF recurrence in patients without structural heart disease however predictors of treatment success are insufficiently studied. Objective: To assess clinical characteristics associated with flecainide treatment success in patients with recurrent AF. Methods: Using hospital medical records, 135 consecutive adult AF patients who were referred for in-hospital initiation of flecainide were included (median age 62 (IQR 53-70) years, 35% females, 28% persistent AF, median CHA2DS2-VASc score 1, median follow up time 14.5 (IQR 3.3-32.7) months). Patient characteristics at admission, including left atrial enlargement (LAE) assessed as LA volume index >34 ml/m2, were retrieved from medical records. Kaplan Meier curve and Cox regression analysis were used to analyse the association between the clinical characteristics and the likelihood of the drug discontinuation due to failed rhythm control efficacy (primary endpoint) or discontinuation for any reason (secondary endpoint). Results: By the end of follow up 88 patients (65.0%) had continued flecainide therapy. Reasons for discontinuation were failed efficacy (16.0%), side effects (7.0%) or safety issues (16.0 %) such as proarrhythmia (6.7%), heart failure (2.2%), coronary heart disease (1.5%), QRS widening (1.5%), QTc ≥500 ms (0.7%) or AV block II (0.7%). Age ≥60 years, male gender, height and LAE were significant predictors of therapy discontinuation in the univariate analysis, however only LAE (HR=3.9 95% CI 1.1-13.5 for the primary (Figure A) and HR=2.5 95%CI 1.3-4.9 for the secondary endpoints) and age ≥60 years (HR=3.9 95% CI 1.1-11.9 for the primary and HR=2.2 95%CI 1.1-4.3 for the secondary endpoint) remained independent predictors of therapy discontinuation in the multivariate analysis. The outcome did not differ between paroxysmal and persistent AF (Figure B). [Formula presented] [Formula presented] Conclusion: LAE and age ≥60 years were associated with flecainide rhythm control failure in patients with recurrent AF. The vast majority of all treatment failures occured within 6 months from the treatment start. AF type did not significantly predict treatment efficacy.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- flecainide
- adult
- atrial fibrillation
- atrioventricular block
- CHA2DS2-VASc score
- clinical feature
- cohort analysis
- conference abstract
- controlled study
- drug efficacy
- drug safety
- drug therapy
- drug withdrawal
- female
- follow up
- gender
- heart failure
- heart left atrium
- heart proarrhythmia
- human
- ischemic heart disease
- Kaplan Meier method
- major clinical study
- male
- medical record
- middle aged
- outcome assessment
- persistent atrial fibrillation
- QTc interval
- retrospective study
- side effect
- treatment failure
- univariate analysis
Publikations- och innehållstyp
- kon (ämneskategori)
- ref (ämneskategori)
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