![]() There were no clinical risk factors for atrial fibrillation, including no history of hypertension, obstructive sleep apnoea, alcohol overuse, diabetes or heart failure. He had no previous invasive procedures for atrial fibrillation, and flecainide was the first line antiarrhythmic agent used in this man. This occurred on the background of a 15 year history of paroxysmal atrial fibrillation, treated with flecainide, orally, 100 mg twice daily, without concomitant use of an AV nodal blocking agent at the time of presentation. Despite this being a unanimous recommendation, there is no current evidence or guideline on the type or dose of AV nodal blocking agent needed to reduce this risk.Ī 62 year old Caucasian medical professional, with reliable compliance, presented to the cardiology clinic with a two hour history of palpitations, chest tightness and presyncope. As such, current guidelines recommend the co-prescription of AV nodal blocking agents together with class 1c agents to prevent this complication. Flecainide, a class 1c antiarrhythmic, has been reported to convert atrial fibrillation to atrial flutter with 1:1 conduction to the ventricles, and atrioventricular (AV) nodal blocking agents are said to offer some protection from this event. This can potentially be a life threatening complication, if the rhythm degenerates into ventricular fibrillation. This class of medications is reported to cause 1:1 atrial flutter in 3.5–5% of patients chronically treated, due to slowing of atrial rate. Ĭlass 1c antiarrhythmics are commonly prescribed, as they are effective in maintaining sinus rhythm. ![]() AF is a risk factor for stroke, and it is associated with increased mortality, as well as a range of complications, including heart failure, myocardial infarction, chronic kidney disease, venous thromboembolism and dementia. It was estimated in 2016, that 46.3 million individuals worldwide have AF, and AF prevalence is thought to have increased threefold over the last 50 years. The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.Ītrial fibrillation (AF) is a common problem, with a lifetime risk of 1 in 4 of developing the condition. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
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