Dofetilde and flecainide combination: the serendipity of successful treatment of atrial fibrillation after failed ablation.

Abstract

Antiarrhythmic drugs (AADs) and catheter ablation (CA) are guideline-directed rhythm control treatment for atrial fibrillation (AF). AADs are rarely used in combination to treat AF. Dofetilde (class III agent) and flecainide (class Ic agent) are contraindicated in patients with renal dysfunction and coronary artery disease respectively. We describe a case of a patient who refused non-pharmacological treatment for recurrent AF after CA, but was treated successfully with dofetilide and flecainide combination. The patient's taking the combination was serendipitous initially. Both drugs were continued nonetheless, as it was the combination and not the individual drug that controlled AF in our patient.