Copyright © 1997 by the European Society of Cardiology.
© 1997 The European Society of Cardiology
Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation
Results of a randomized, double-blind, controlled study
Division of Cardiology, Hospital Universitario Virgen de las Nieves Granada, Spain
*Medical Department of Laboratorios Knoll Madrid, Spain
Received 22 April 1997; accepted 25 April 1997.
Correspondence: José Azpitarte, Division of Cardiology, Hospital Universitario Virgen de las Nieves, Avda de la Constitución 100, 18012 Granada, Spain
Abstract
AIMS: To evaluate the efficacy and safety of a single loading oral dose of propafenone in the interruption of recent-onset atrial fibrillation.
METHODS: After a complete medical history, physical examination, 12-lead ECG, chest X-ray, and routine biochemical laboratory testing, 55 consecutive patients with recent-onset atrial fibrillation were randomized double-blind in the emergency department for the administration of either a single oral dose (450 to 750 mg) of propafenone (29 cases) or a placebo (26 cases). After the 24-h observation period, comprehensive echocardiographic examination was performed.
RESULTS: The groups were homogeneous as regards biological, clinical and echocardiographic characteristics. Two hours after treatment, 12 patients (41%) on propafenone but only two (8%) on placebo had converted to sinus rhythm (P=0·005). This striking difference was maintained 6 h after treatment (65 vs 31%; P=0·015) but lessened at 12 h (69% vs 42%; P=0·060) and was insignificant at the end of the 24-h treatment period (79% vs 73%; P=0·752). Apart from hypotension, transient in three cases and sustained in one whose later echocardiographic examination demonstrated left systolic ventricular dysfunction, propafenone was well tolerated.
CONCLUSIONS: Although there is no significant difference in the rates of conversion 24 h after treatment, propafenone works faster than placebo in achieving sinus rhythm. This rapid action of oral propafenone can be useful to solve quickly the clinical problems of a high proportion of patients arriving at the emergency department with acute atrial fibrillation.
Key Words: Atrial fibrillation • propafenone • randomized trial
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