Hand-held breath-actuated nebulizer for delivery of flecainide to the heart: Dose-concentration dependent pharmacokinetics and QRS interval prolongation of the inhaled flecainide in healthy volunteers.

Belardinelli | Circulation 2017; 136:A16836

Oral and IV routes for delivery of flecainide (FLEC) for acute cardioversion of atrial fibrillation (AF) have drawbacks: high doses (150-300 mg) and 2- to 4- hours wait time for cardioversion with oral dosing and hospitalization for IV administration. Studies in large animal models of AF suggest that FLEC administered via inhalation (IH) may convert AF rapidly at relatively low doses. Thus, FLEC-IH could be effective at low doses and shorten the time to cardioversion to minutes without requiring emergency room visits.

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