Oral cardioversion with flecainide in supraventricular arrhythmias

Flecainide is a class 1C antiarrhythmic drug with proven efficacy by the intravenous route in terminating supraventricular arrhythmias. Pharmacokinetic studies evidenced how its administration as acute oral loading dose obtains therapeutic drug levels within 2-3 hours after administration. We therefore planned a controlled study evaluating the efficacy of a single oral loading dose of flecainide (300 mg q.d.) in converting recent onset atrial fibrillation to sinus rhythm. The data confirmed the high efficacy of this kind of treatment (84% of conversion within 8 hours). Therefore acute oral loading with FLE is proposable for extensive in-hospital employment in order to treat acutely, under clinical observation, supraventricular arrhythmias in patients without heart failure or left ventricular disfunction.