Importance of left atrial diameter and atrial fibrillatory frequency for conversion of persistent atrial fibrillation with oral flecainide

This study, determined the efficacy and safety of an oral flecainide-loading protocol (300-mg bolus followed by 200 to 300 mg/day) in 18 patients with no overt structural heart disease having atrial fibrillation (AF) of >24 hours in duration. Sinus rhythm was restored in 50% of patients,within a 72-hour observation period and was predicted by both echocardiographically determined left atrial diameter and fibrillatory frequency obtained from the surface electrocardiogram. Therefore, in patients with small left atria and/or a low fibrillatory frequency, a conversion attempt with oral flecainide may be warranted, irrespective of AF duration.