Therapy

• flecainide ^a

Why?

• Flecainide is more effective at cardioversion than procainamide ^a , propafenone ^a , digoxin ^a or verapamil ^a , though not clearly better than amiodarone. ^d
• Watch for severe hypotension. ^a

Flecainide is more effective at cardioversion than procainamide, digoxin or verapamil

Patient	Treatment	Comparison	Outcome	CER	RRR (95% CI)	NNT (95% CI)
acute AF a	flecainide	procainamide	sinus rhythm at 60 minutes	62%	32% (13% to 48%)	3 (2 to 8)
recent onset AF a	flecainide	digoxin	sinus rhythm at 6 hours	35%	32% (13% to 50%)	3 (2 to 8)
recent onset AF a	flecainide	digoxin	severe hypotension at 6 hours	5.9%	-270% (-1100% to -9%)	-6 (-37 to -3)
paroxysmal AF a	flecainide	verapamil	sinus rhythm at 60 minutes	5.0%	1300% (100% to 9600%)	2 (1 to 2)

Flecainide is more effective at cardioversion than propafenone

Patient	Treatment	Comparison	Outcome	CER	OR (95% CI)	NNT (95% CI)
persistent or paroxysmal AF a	flecainide	propafenone	sinus rhythm at 24 hours	30%	5.1 (2.3 to 11.0)	5.1 (2.3 to 11.0)