Arrhythmias & electrophysiology
Safety and efficacy of long-term sodium channel blocker therapy for early rhythm control: the EAST-AFNET 4 trial
Authors' conclusion
Long-term therapy with flecainide or propafenone appeared to be safe in the EAST-AFNET 4 trial to deliver effective ERC therapy, including in selected patients with stable cardiovascular disease such as coronary artery disease and stable HF.
Study context
- Population
- Patients randomised to early rhythm control in EAST-AFNET 4
- Participants
- 1,395 early rhythm control (ERC) patients
- Comparison
- SCB vs never SCB within early rhythm control
- SCBn = 689
- Primary endpoint
- Primary safety outcome (death, stroke or serious adverse events related to rhythm control therapy) and primary efficacy outcome (CV death, stroke, hospitalization for worsening heart failure (HF) or ACS) during SCB intake
Methodological detailsSCB median therapy duration 1153 [237, 1828] days, Protocol discouraged flecainide and propafenone with reduced LVEF and suggested stopping upon QRS prolongation >25% on therapy
- SCB median therapy duration 1153 [237, 1828] days
- Protocol discouraged flecainide and propafenone with reduced LVEF and suggested stopping upon QRS prolongation >25% on therapy
Primary result
As reported in the abstract
Primary efficacy outcome
SCB
3/100
99 of 689
SCBnever
4.9/100
150 events
P < 0.001
Further findings
| Outcome | SCB | SCBnever |
|---|---|---|
| Sinus rhythm · 2 years | 88 | 82 |
Sinus rhythm · 2 years
- Similar between groups
Safety
| Outcome | SCB | SCBnever | P value |
|---|---|---|---|
| Primary safety outcome (death, stroke or serious adverse events related to rhythm control therapy) | 2.9/100 patient-years | 4.2/100 patient-years | adjusted P = 0.015 |
Original publication
Safety and efficacy of long-term sodium channel blocker therapy for early rhythm control: the EAST-AFNET 4 trial. Europace. Published 4 May 2024. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →