Arrhythmias & electrophysiologyRandomised controlled trial
Efficacy and Safety of Flecainide Versus Amiodarone for the Cardioversion of paroxysmal Atrial Fibrillation in Patients with Coronary Artery Disease without evidence of residual ischemia: The FLECA-ED Randomized Clinical Trial
- investigator-initiated, multicenter, open-label, randomized trial
- assigned 1:1
- 24-hour ambulatory ECG monitoring
- emergency department
Authors' conclusion
In patients with paroxysmal AF and CAD without evidence of residual and active ischemia, intravenous flecainide was superior to amiodarone for acute cardioversion, with faster conversion to sinus rhythm and fewer hospital admissions. No serious ventricular proarrhythmia through 24 hours was observed, a hypothesis-generating finding.
Study context
- Population
- Adults with recent-onset paroxysmal atrial fibrillation (AF) and documented coronary artery disease (CAD) without residual or active ischemia presenting to the emergency departmentpatients underwent randomization · flecainide 42 · amiodarone 45
- Participants
- Eighty-seven adults
- Comparison
- intravenous flecainide with intravenous amiodarone for cardioversion of recent-onset paroxysmal atrial fibrillation (AF)
- flecainiden = 42
- amiodaronen = 45
- Primary endpoint
- Conversion to sinus rhythm (primary efficacy end point)
- Follow-up
- Within 6 hours
Primary result
As reported in the abstract
P < 0.001
Further findings
Median time to conversion
P < 0.001
Hospital admission
P < 0.001
Safety
Ventricular proarrhythmic events · within 24 hours
- No ventricular proarrhythmic events occurred within 24 hours in either group
- The primary safety end point (composite within 6 hours) is named but no result for it is reported
Deaths · through 30 days
- no deaths were recorded through 30 days
Original publication
Efficacy and Safety of Flecainide Versus Amiodarone for the Cardioversion of paroxysmal Atrial Fibrillation in Patients with Coronary Artery Disease without evidence of residual ischemia: The FLECA-ED Randomized Clinical Trial. Heart Rhythm. Published 6 October 2026. doi:10.1016/j.hrthm.2026.09.051
Summarised from the published abstract; every number is checked against it