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

2020 ◽  
Vol 34 (3) ◽  
pp. 383-389
Author(s):  
Stylianos Tzeis ◽  
◽  
Dimitrios Tsiachris ◽  
Dimitrios Asvestas ◽  
Spiridon Kourouklis ◽  
...  
2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Tzeis ◽  
D Tsiachris ◽  
S P Kourouklis ◽  
F Patsourakos ◽  
D Karlis ◽  
...  

Abstract Background/Introduction Atrial fibrillation (AF) is the most common cardiac arrhythmia with a considerable impact on patients' quality of life (QoL). Flecainide acetate, is a class Ic antiarrhythmic agent, recommended as first line treatment in AF patients without underlying structural heart disease. Purpose This prospective, multicenter, nationwide, observational study aimed to evaluate the effect of oral treatment with controlled-release (CR) flecainide administered once daily on AF patients' QoL and treatment compliance during a 12-week period. Methods A total of 70 cardiologists participated in the study enrolling consecutive adult patients with paroxysmal or persistent AF, 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) measured at baseline and at 12 weeks of treatment. Results In total, 679 patients (53.2% females, mean age 65.9±11.7 years, 86.9% paroxysmal AF) were included in the analysis. At least one prior antiarrhythmic treatment was documented in 43.8% of patients. The initial daily dose of flecainide CR was 100mg in 71.7% of the patients, with a titration to 200mg by the end of study achieved in 67%. In 93.6% of patients an excellent compliance score (100%) to treatment was recorded at the end of the study period. Treatment with flecainide CR resulted in a significant improvement in QoL as presented in the table. Table 1 CCS-SAF score Baseline (Week 0) End of study visit (Week 12) N=679 N=634 Class 1 (minimal effect on QoL) 343 (50.5) 464 (73.2) Class 2 (minor effect on QoL) 253 (37.2) 140 (22.1) Class 3 (moderate effect on QoL) 73 (10.8) 28 (4.4) Class 4 (severely impairs QoL) 10 (1.5) 2 (0.3) CCS-SAF continuous score   Mean ± SD 1.64±0.73 1.32±0.57 Change from baseline‡   Mean (95% CI) −0.325 (−0.379, −0.271)   p-value <0.0001 ‡Paired t-test is used. Conclusions This prospective, multicenter, observational study demonstrated that treatment of AF patients with flecainide CR, was associated with a significant improvement of QoL and excellent compliance to treatment. Acknowledgement/Funding Sponsored by WinMedica S.A.


2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Demenko ◽  
G.A Chumakova

Abstract Background Mental disorders in patients with cardiovascular disease have a significant impact on the course, the prognosis of the underlying disease and quality of life (QOL). Objective We aimed to examine the prevalence of anxiety and depressive disorders and their impact on the quality of life in patients with atrial fibrillation (AF). Materials and methods In 52 with permanent AF and 50 with paroxysmal AF patients, we administered the depression scale Tsung, the scale of situational anxiety (SA) and personal anxiety (PA) Spielberger-Hanin; QOL was assessed the SF-36 quality of life assessment scale. Correlation analysis using Spearman's rank correlation coefficient. Results The prevalence symptoms mild depression situational or neurotic genesis was 21.1% (12 patients) in Group 1 and 12.0% (6 patients) in Group 2 (p&gt;0.05). Subdepressive state was two percents of patients in Group 1 and Group 2. The incidence SA was 59.6% (31 patients) in Group 1 and 52.0% (26 patients) in Group 2. The incidence PA was 74.0% (37 patients) in Group 2 and 67.3% (35 patients) in Group 1. The average score the physical component of health (PCH) was 29,8±4,3 in Group 1, the mental component of health (MCH) – 49.5±7.4 points; p&lt;0.05. In Group 2: PCH – 44.8±6.6 points, MCH – 26.6±7.5 points; p&lt;0.05. Correlation analysis showed negative strong correlations between SA and MCH (r=−0.64, p=0.0005) and between PA and MCH (r=−0.69, p&lt;0.0001), between SA and PCH (r=−0.71, p=0.0001), between depression and PCH (r=−0.69, p=0.023). Negative statistically significant correlation between depression and MCH (r=−0.69, p=0.54) and negative medium correlation between depression and PCH (r=−0.64, p=0.23). Conclusion These findings suggest that we did not identify patients with symptoms of a true depressive (that can cause pseudodementia and influenced to complete tests). 16.5% patients with AF had mild depression of situational or neurotic genesis. Depression may be a pathogenetic factor of AF or develop because of paroxysms AF – psychological stress. More than 50% patients in Group 1 and Group 2 had an increased anxiety score. SA is more common in patients with permanent AF, probably because older people difficult to adapt to a new situation. PA is more common in patient with paroxysmal AF, probably because disease is sudden and causes anxiety. The PCH of QOL is more impairment in patients with permanent AF, because complications (for example heart failure) impairment physical activity. However, PCH also reduced in patient with paroxysmal AF, because disease is sudden may occur during physical activity. The MCH of QOL is more impairment in patients with paroxysmal AF, because waiting attack effect on mental health and social functioning. An increased level of anxiety and depression negatively affected the mental and physical health of patients with AF. Funding Acknowledgement Type of funding source: None


Author(s):  
Bert Vandenberk ◽  
Laurens Lauwers ◽  
Tomas Robyns ◽  
Christophe Garweg ◽  
Rik Willems ◽  
...  

2021 ◽  
Vol 34 ◽  
pp. 100791
Author(s):  
Victoria Jansson ◽  
Lennart Bergfeldt ◽  
Jonas Schwieler ◽  
Göran Kennebäck ◽  
Aigars Rubulis ◽  
...  

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
K Nakajima ◽  
T Kimura ◽  
T Fujisawa ◽  
Y Katsumata ◽  
T Nishiyama ◽  
...  

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