Efficacy and safety at Moricizine in the maintenance at sinus rhythm in patients with recurrent atrial fibrillation

Maintenance of sinus rhythm is the primary goal of antiarrhythmic drug ther apy for recurrent atrial fibrillation (AF). However, concern about proarrhy thmic and negative inotropic effects has led to increasing reluctance to ad minister antiarrhythmic agents for this non-life-threatening arrhythmia. Mo ricizine is well tolerated in a wide variety of patients, and therefore, ma y be a safe and effective agent for treating AF. We retrospectively assesse d the efficacy and safety of moricizine (mean dose 609 +/- 9 mg/day) in 85 consecutive patients with recurrent AF (2.6 +/- 0.5 years duration, 1.6 +/- 1 failed antiarrhythmic drugs). Structural heart disease was present in 69 (81%), but no recent myocardial infarct (less than or equal to 90 days) wa s present; mean left atrial sire was 46 +/- 1 mm, and mean left ventricular election fraction was 0.51 +/- 0.01. Moricizine was discontinued because o f unsuccessful direct-current cardioversion (n = 5) or clinically unaccepta ble side effects (n = 6); 6 patients developed transient side effects not r equiring discontinuation. Of the 74 patients continuing therapy, 68% remain ed in sinus rhythm after 6 months, and 59% after 12 months. During a follow -vp (21 +/- 2 months), there were neither deaths nor adverse effects requir ing discontinuation of therapy. Thus, moricizine was effective, safe, and w ell tolerated in our patient cohort with AF. (C) 2001 by Excerpta Medica, I nc.