BMJ 2007;334:637 (24 March), doi:10.1136/bmj.39143.720602.BE
Practice
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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 in
the United Kingdom,
1 about 200 000 of whom have recurrent episodes.
Although such episodes often resolve spontaneously and within
48 hours,
2 patients may be distressed by symptoms of palpitations,
dizziness, fatigue, or chest pain. Such attacks generally respond
to antiarrhythmic agents (such as a single intravenous dose
of propafenone or flecainide),
3 which are usually administered
under monitoring in hospital.
Here we propose that patients could self treat with oral propafenone or flecainide, using a "pill in the pocket" approach (thereby not needing to go to hospital), as suggested in recent national (National Institute for Health and Clinical Excellence) and international guidelines.4 5 For details of our methods, please see the box on bmj.com.
- Currently, patients without severe heart disease who have infrequent paroxysmal atrial fibrillation require hospital intervention for symptomatic episodes
- For selected patients, self treatment strategy is feasible, . . . [Full text of this article]
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This article has been cited by other articles:
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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
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