Treatment of recent onset atrial fibrillation with intravenous sotalol and/or flecainide.

Aim: The purpose of our study (conducted between August 1995 and September 1996) was to evaluate prospectively the efficacy of intravenous administration (in 10 min) of sotalol, flecainide or the combination of these drugs to restore sinus rhythm in patients (without cardiac/pulmonary failure) who came to the First Heart Aid of our hospital with atrial fibrillation lasting less than 24 h.

Methods And Results: Patients in whom the rhythm was not converted to sinus rhythm by intravenous sotalol within 60 min, we started to give flecainide intravenously (2 mg/kg). In patients on oral beta blockade we started flecainide intravenously (2 mg/kg) over 10 min.

A transcardiac lead system for identification and termination of supraventricular and ventricular tachycardia.

The value of a transcardiac lead system (coronary sinus to right ventricular apex) to record atrial and ventricular electrical activity and its pacing capabilities was assessed in 20 patients with a variety of tachycardias (atrial tachycardia in 3 patients, atrial flutter in 4, intranodal tachycardia in 6, circus movement tachycardia using an accessory pathway in 1 patient, and ventricular tachycardia in 9). The transcardiac lead invariably showed both atrial and ventricular electrical activity during sinus rhythm and tachycardias, allowing application of the same criteria as used when analyzing cardiac rhythm on the surface electrocardiogram. Atrial complexes had a mean amplitude of 4.

Lack of clinically significant beta-blocking effect of propafenone.

To study possible beta-blocking effects of propafenone, a class 1c antiarrhythmic agent, electrocardiographic variables were studied at rest and during exercise. Forty-two patients with symptomatic ventricular arrhythmias were included. In 31 patients, exercise electrocardiograms before and after propafenone were available for study.