In this pilot and feasibility study, the investigators will enroll patients with frequent symptomatic episodes of atrial fibrillation (AF) in a cross-over study testing two different classes of anti arrhythmic drugs (AADs). This pilot and feasibility study will provide preliminary data for a larger study in which the investigators will test the hypothesis that a common AF genetic risk allele modulates response to different AADs.

NCT02347111

Conditions

1. Atrial Fibrillation

Interventions

1. Drug: Flecainide
2. Drug: Sotalol

MeSH:Atrial Fibrillation

HPO:Atrial fibrillation Paroxysmal atrial fibrillation

Blood processing, DNA extraction, and genotyping: Blood samples will be drawn into ethylenediamenetetraacetic acid (EDTA) tubes and immediately refrigerated at 4° C. Plasma will be separated by centrifugation and stored at -80° C. DNA will be extracted from the buffy coat using a commercially available kit (Qiagen Puregene, Valencia, California) and stored at -20° C. Study participants will be genotyped for three common chr4q25 SNPs (rs2200733, rs17570669, and rs3853445) using Sanger sequencing.

[In addition, a number of exploratory analyses will be performed on other AF risk alleles, particularly the other 3 most common chr4q25 AF SNPs (rs2200733, rs17570669, rs3853445) associated with AF in EAs26 to determine if any of them modulate response to flecainide and sotalol, using the same test for the primary analysis based on the AF burden scores.