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Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias. Report from the Flecainide and Propafenone Italian Study (FAPIS) Group.
Eur Heart J 1995; 16(12):1943-51EH

Abstract

In order to compare the long-term safety of flecainide and propafenone, an open label, randomized, parallel group study was performed in 335 patients with paroxysmal atrial fibrillation (n = 200) or paroxysmal supraventricular tachycardia (n = 135), and no history of heart disease. Patients were treated with an initial daily dose of flecainide 100 mg (n = 72) or propafenone 450 mg (n = 63) for paroxysmal supraventricular tachycardia and flecainide 200 mg (n = 97) or propafenone 450 mg (n = 103) for paroxysmal atrial fibrillation. Dose escalations were permitted after > or = 2 attacks, up to a maximum of flecainide 300 mg or propafenone 900 mg.day-1.Follow-up duration was 12 months, or when patients stopped the treatment as a result of inadequate efficacy or adverse experiences. Twelve patients on flecainide reported 16 cardiac adverse experiences, of whom six discontinued the treatment. Seven propafenone patients had eight cardiac adverse experiences, of whom five discontinued the treatment. Serious proarrhythmic events were infrequent: one case of ventricular tachycardia on propafenone: two cases of atrial fibrillation with rapid ventricular response on flecainide, associated in one patient with pulmonary oedema. An intention-to-treat analysis showed that the probability of 12 months' safe and effective treatment of paroxysmal supraventricular tachycardia was 93% for flecainide and 86% for propafenone (P = 0.24), whereas in paroxysmal atrial fibrillation it was 77% for flecainide and 75% for propafenone (P = 0.72). In conclusion, flecainide and propafenone were safe in the long-term treatment of patients with paroxysmal supraventricular tachyarrhythmias and without evidence of clinically significant heart disease.

Authors+Show Affiliations

Division of Cardiology, San Donato Hospital, University of Pavia, Italy.No affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

8682031

Citation

Chimienti, M, et al. "Safety of Flecainide Versus Propafenone for the Long-term Management of Symptomatic Paroxysmal Supraventricular Tachyarrhythmias. Report From the Flecainide and Propafenone Italian Study (FAPIS) Group." European Heart Journal, vol. 16, no. 12, 1995, pp. 1943-51.
Chimienti M, Cullen MT, Casadei G. Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias. Report from the Flecainide and Propafenone Italian Study (FAPIS) Group. Eur Heart J. 1995;16(12):1943-51.
Chimienti, M., Cullen, M. T., & Casadei, G. (1995). Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias. Report from the Flecainide and Propafenone Italian Study (FAPIS) Group. European Heart Journal, 16(12), pp. 1943-51.
Chimienti M, Cullen MT, Casadei G. Safety of Flecainide Versus Propafenone for the Long-term Management of Symptomatic Paroxysmal Supraventricular Tachyarrhythmias. Report From the Flecainide and Propafenone Italian Study (FAPIS) Group. Eur Heart J. 1995;16(12):1943-51. PubMed PMID: 8682031.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias. Report from the Flecainide and Propafenone Italian Study (FAPIS) Group. AU - Chimienti,M, AU - Cullen,M T,Jr AU - Casadei,G, PY - 1995/12/1/pubmed PY - 2001/3/28/medline PY - 1995/12/1/entrez SP - 1943 EP - 51 JF - European heart journal JO - Eur. Heart J. VL - 16 IS - 12 N2 - In order to compare the long-term safety of flecainide and propafenone, an open label, randomized, parallel group study was performed in 335 patients with paroxysmal atrial fibrillation (n = 200) or paroxysmal supraventricular tachycardia (n = 135), and no history of heart disease. Patients were treated with an initial daily dose of flecainide 100 mg (n = 72) or propafenone 450 mg (n = 63) for paroxysmal supraventricular tachycardia and flecainide 200 mg (n = 97) or propafenone 450 mg (n = 103) for paroxysmal atrial fibrillation. Dose escalations were permitted after > or = 2 attacks, up to a maximum of flecainide 300 mg or propafenone 900 mg.day-1.Follow-up duration was 12 months, or when patients stopped the treatment as a result of inadequate efficacy or adverse experiences. Twelve patients on flecainide reported 16 cardiac adverse experiences, of whom six discontinued the treatment. Seven propafenone patients had eight cardiac adverse experiences, of whom five discontinued the treatment. Serious proarrhythmic events were infrequent: one case of ventricular tachycardia on propafenone: two cases of atrial fibrillation with rapid ventricular response on flecainide, associated in one patient with pulmonary oedema. An intention-to-treat analysis showed that the probability of 12 months' safe and effective treatment of paroxysmal supraventricular tachycardia was 93% for flecainide and 86% for propafenone (P = 0.24), whereas in paroxysmal atrial fibrillation it was 77% for flecainide and 75% for propafenone (P = 0.72). In conclusion, flecainide and propafenone were safe in the long-term treatment of patients with paroxysmal supraventricular tachyarrhythmias and without evidence of clinically significant heart disease. SN - 0195-668X UR - https://www.unboundmedicine.com/medline/citation/8682031/Safety_of_flecainide_versus_propafenone_for_the_long_term_management_of_symptomatic_paroxysmal_supraventricular_tachyarrhythmias__Report_from_the_Flecainide_and_Propafenone_Italian_Study__FAPIS__Group_ L2 - https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/oxfordjournals.eurheartj.a060852 DB - PRIME DP - Unbound Medicine ER -