Some patients with paroxysmal atrial fibrillation should carry flecainide or propafenone to self treat

doi:10.1136/bmj.39143.720602.BE

BMJ 2007;334:637 (24 March), doi:10.1136/bmj.39143.720602.BE

Practice

Change page

Some patients with paroxysmal atrial fibrillation should carry flecainide or propafenone to self treat

A John Camm, British Heart Foundation professor of clinical cardiology, Irina Savelieva, senior research fellow

St George's, University of London, London SW17 0RE

Correspondence to: A J Camm, Division of Cardiac and Vascular Sciences, St George's, University of London, London SW17 0REjcamm@sgul.ac.uk

The first 150 words of the full text of this article appear below.

The clinical problem

Atrial fibrillation affects up to 1.5% of the population inthe United Kingdom,¹ about 200 000 of whom have recurrent episodes.Although such episodes often resolve spontaneously and within48 hours,² patients may be distressed by symptoms of palpitations,dizziness, fatigue, or chest pain. Such attacks generally respondto antiarrhythmic agents (such as a single intravenous doseof propafenone or flecainide),³ which are usually administeredunder monitoring in hospital.

Here we propose that patients could self treat with oral propafenoneor flecainide, using a "pill in the pocket" approach (therebynot needing to go to hospital), as suggested in recent national(National Institute for Health and Clinical Excellence) andinternational guidelines.⁴ ⁵ For details of our methods, pleasesee the box on bmj.com.

• Currently, patients without severe heartdisease who have infrequent paroxysmal atrial fibrillation requirehospital intervention for symptomatic episodes

• For selectedpatients, self treatment strategy is feasible, . . . [Full text of this article]

The evidence for change

Barriers to change

How should we change our practice?

CiteULike

Complore

Connotea

Del.icio.us Add to Digg

Digg

StumbleUpon Add to Technorati

Technorati What's this?

This article has been cited by other articles:

Camm, A. J., Kirchhof, P., Lip, G. Y.H., Savelieva, I., Ernst, S. (2009). CHAPTER 29 Atrial Fibrillation. ESC Textbook of Cardiovascular Medicine 2: med-9780199566990-chapter-med-9780199566990-chapter [Abstract] [Full text]