Atrial Fibrillation

Question 1

First class drugs

Answer 1

• Beta blockers
• Calcium channel blockers
• Digoxin
• Pill in a pocket
• Flecainide
• Sotalol
• Amiodarone/Dronedarone

Question 2

When to take pill in a pocket

Answer 2

History of infrequent, asymptomatic episodes of paroxysmal AF lasting at least 6 hours not associated with major haemodynamic deterioration and no underlying structural heart disease.

Question 3

How and when to take pill in a pocket

Answer 3

For the first time: The patient must present to A&E to be offered a single oral dose of Flecainide 300mg under medical supervision and ECG monitoring
For future use: Rest until palpitations stop or up to 4 hours following self-administration of Flecainide 300mg.

In the event that the symptoms deteriorate or medications fails to terminate the AF after 4 hours, they must report to A&E.

Must never take more than 300mg Flecainide within any 24 hour period.