{"id":"a855a62c732d","type":"article","url":"https://hartvaat.nl/2016/11/01/flecainide-metoprolol-combinatie-vermindert-af-recidieven-1-jaarsresultaten/","title":"Flecaïnide-metoprolol combinatie vermindert AF-recidieven: 1-jaarsresultaten","title_en":"Flecainide-metoprolol combination reduces atrial fibrillation clinical recurrences and improves tolerability at 1-year follow-up in persistent symptomatic atrial fibrillation.","category":"atriumfibrilleren","category_label":"Atriumfibrilleren","professions":["apotheker","cardioloog"],"tags":[],"journal":"Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology","doi":"10.1093/europace/euv462","source_url":"https://doi.org/10.1093/europace/euv462","authors":["Alessandro Capucci","Luca Piangerelli","Jenny Ricciotti","Domenico Gabrielli","Federico Guerra"],"significance":6,"published":"2016-11-01","source_date":"2016-11-01","image":"","kennis":[],"congress":"","summary_en":"This study showed that the flecainide-metoprolol combination reduces AF recurrence and improves tolerability compared with either agent alone, supporting a synergistic antiarrhythmic approach for paroxysmal atrial fibrillation.","created":"2026-07-03T10:26:22Z","updated":"2026-07-03T13:25:42Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die aantoont dat de combinatie flecaïnide-metoprolol het klinisch recidief van AF vermindert en de verdraagbaarheid verbetert na 1 jaar follow-up. Praktisch relevant voor de farmacologische ritmecontrolestrategie.","abstract_original":"AIMS: Atrial fibrillation (AF) affects ∼2% of the total population. In order to prevent AF recurrences, many anti-arrhythmic drugs are currently available, but most of them are burdened by serious side effects and suboptimal efficacy. The aim of the present study was to test efficacy and safety of a combination of flecainide and metoprolol in preventing AF clinical recurrences. METHODS AND RESULTS: This study is a monocentric, prospective, randomized, open-blinded trial on 173 patients with a recent episode of paroxysmal or persistent AF. Patients were randomized into group A (flecainide + metoprolol; n = 80), group B (flecainide only; n = 72), or group C (metoprolol only; n = 21). Main exclusion criteria were recent acute coronary syndrome, heart failure New York Heart Association class III-IV, left ventricular ejection fraction <0.40, atrioventricular conduction disorders, and severe bradycardia. Primary endpoint was symptomatic recurrence over 1-year follow-up. Secondary endpoint was quality of life (QoL) over 1-year follow-up, as assessed by the SF-36 and Atrial Fibrillation Severity Scale questionnaires. Combination therapy with flecainide and metoprolol significantly reduced recurrences at 1-year follow-up when compared with flecainide alone in the whole population (66.7 vs. 46.8%; P < 0.001) and in patients with persistent AF (71.1 vs. 43.6%; P = 0.025) while adding beta-blocker therapy to paroxysmal AF showed no benefit over IC anti-arrhythmic drug-only. Patients randomized to combination therapy experienced a significant improvement of QoL when compared with those assigned to a flecainide-only regimen irrespective of AF type. CONCLUSION: Flecainide-metoprolol combination therapy improves effectiveness of rhythm control in persistent symptomatic AF and increases tolerability, with a concomitant reduction of side effects and a better compliance."}