The DOI matches its Crossref record.
Atrial flutter can be terminated by a class III antiarrhythmic drug but not by a class IC drug
Abstract
In atrial flutter, chemical conversion with class I drugs is often unsuccessful, whereas class III drugs seem more promising. The different electrophysiological effects of these drugs may explain this discrepancy. To date, only experimental data show the differential effects of these drugs on conversion rate and atrial flutter cycle length. This study evaluates the effects of the class IC antiarrhythmic drug flecainide, and of dofetilide, a new class III drug, on conversion rate and flutter cycle length in patients with atrial flutter. Flecainide (11 patients) was given as an intravenous bolus of 2 mg.kg-1 in 10 min and dofetilide (10 patients) as a maximum intravenous bolus of 8 micrograms.kg-1 in 15 min. Baseline characteristics were comparable between both groups. Only one patient treated with flecainide converted to sinus rhythm. This patient showed the largest flutter cycle length increase (280 to 420 ms). By contrast, seven of the 10 patients treated with dofetilide converted to sinus rhythm. Patients treated with flecainide showed a significantly larger increase in atrial flutter cycle length at the end of the infusion compared to the dofetilide-treated patients (from 226 +/- 28 to 317 +/- 52 ms vs from 221 +/- 26 to 239 +/- 39 ms, respectively). In conclusion, dofetilide is more effective than flecainide in the conversion of atrial flutter to sinus rhythm, despite the fact that flecainide produced a more prolonged flutter cycle length. Thus, action potential prolongation in the absence of conduction slowing seems more effective in terminating human atrial flutter than depression of the excitability.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Dofetilide and ibutilide, pure class III AADs, are very effective for interrupting AFL in intravenous administration, while Class Ia and Ic drugs have little or no effect.138 -142,149”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [138]
Citations
Cited by
Sorted by citations
Hindricks, G., Potpara, T., Dagres, N., Arbelo, E., Bax, J. J., Blomström‐Lundqvist, C., Boriani, G., Castella, M., Dan, G.-A., Dilaveris, P., et al. (2020) · European Heart Journal · doi:10.1093/eurheartj/ehaa612 · Cited by 10,550
Self-citationBrugada, J., Katritsis, D. G., Arbelo, E., Arribas, F., Bax, J. J., Blomström‐Lundqvist, C., Calkins, H. G., Corrado, D., Deftereos, S. G., Diller, G., et al. (2019) · European Heart Journal · doi:10.1093/eurheartj/ehz467 · Cited by 1,312
Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Circulation · doi:10.1161/cir.0000000000000311 · Cited by 595
2015 ACC/AHA/HRS Guideline for the Management of Adult Patients With Supraventricular Tachycardia
Page, R. L., Joglar, J. A., Caldwell, M. A., Calkins, H., Conti, J. B., Deal, B. J., Estes, N. A. M., Field, M. E., Goldberger, Z. D., Hammill, S. C., et al. (2016) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2015.08.856 · Cited by 439
Falk, R. H., Pollak, A., Singh, S. N., & Friedrich, T. (1997) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(96)00506-2 · Cited by 215
“Class IC agents are also documented to have a poor efficacy in terminating atrial flutter (19).”
BackgroundResultInfluential
Metadata
- Authors
- CRIJNS, H. J. G. M., VAN GELDER, I. C., KINGMA, J. H., DUNSELMAN, P. H. J. M., GOSSELINK, A. T. M., & LIE, K. I.
- Affiliations
- University Medical Center Groningen (NL)
- Corresponding author
- CRIJNS, H. J. G. M.
- Venue
- European Heart Journal
- Publisher
- Oxford University Press (OUP)
- Published
- 1994-10
- Volume
- 15
- Issue
- 10
- Pages
- 1403-1408
- ISSN
- 0195-668X (ISSN-L)
- 1522-9645
- OpenAlex
- W1763503342
- Cited by
- 76
- References
- 0
- Citations by year
- 2025: 2 · 2024: 1 · 2023: 3 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 1 · 2016: 4 · 2015: 5 · 2012: 2
- FWCI
- 2.21
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- European Heart Journal (publishedVersion)
- PubMed (publishedVersion)
- University of Groningen research database (University of Groningen / Centre for Information Technology) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial flutter, chemical cardioversion, class III antiarrhythmic agents, class Ic antiarrhythmic drugs, flecainide, dofetilide, conversion to sinus rhythm, action potential prolongation
- MeSH terms
- Anti-Arrhythmia Agents, Atrial Flutter, Double-Blind Method, Echocardiography, Electrocardiography, Female, Flecainide, Heart Conduction System, Humans, Infusions, Intravenous, Male, Middle Aged, Phenethylamines, Sulfonamides
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
