Beneficial Effect of Flecainide Controlled Release on the Quality of Life of Patients with Atrial Fibrillation-the REFLEC-CR Study.

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia with a considerable impact on patients' quality of life (QoL). This prospective, multicenter, observational study aimed to evaluate the effect of oral treatment with controlled-release (CR) flecainide on AF patients' QoL and treatment compliance during a 12-week period. A total of 70 sites enrolled consecutive patients with paroxysmal (PAF) or persistent AF (PerAF), treated with flecainide CR in the context of a rhythm control strategy. The effect on QoL was assessed by the Canadian Cardiovascular Society Severity of Atrial Fibrillation scale (CCS-SAF). In total, 679 patients (53.2% females, 66 ± 11.7years, 86.9% PAF) were included. Prior antiarrhythmic medication had been administered in 43.8% of patients. A daily dose of 200mg was administered to 66.4% of patients by the end of study. Flecainide CR resulted in a significant reduction in the CCS-SAF score (mean (SD)) at the end of the study as compared with baseline (1.32 (0.57) vs 1.64 (0.73), p < 0.0001). Flecainide CR significantly reduced the CCS-SAF score both in PAF (1.27 (0.52) vs 1.61 (0.72), p < 0.0001) as well as in PerAF (1.63(0.77) vs 1.84(0.81), p = 0.017). Overall, 4 (0.6%) patients experienced a total of 6 adverse events during the study period. The compliance to flecainide CR treatment was very high with 93.6% of patients responding that they had not missed any dose during the study period. Treatment with flecainide CR significantly improves QoL in both paroxysmal as well as persistent AF patients, with an excellent safety profile and associated patient compliance.