Therapy

• flecainide ^a  iv or oral  ^a

Why?

• Flecainide is more effective at cardioversion than procainamide ^a , propafenone ^a , amiodarone ^a , digoxin ^a or verapamil. ^a
• Watch for severe hypotension. ^a
• Flecainide given iv leads to faster (by roughly an hour)  but not more successful cardioversion than oral. ^a

Flecainide is more effective at cardioversion than procainamide, propafenone, amiodarone, 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	propafenone	sinus rhythm at 12 hours	72%	25% (3% to 53%)	6 (3 to 33)
recent onset AF a	flecainide	amiodarone	sinus rhythm at 12 hours	54%	41% (12% to 77%)	4 (2 to 10)
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)