Electrophysiological effects of flecainide and propafenone on atrial fibrillation cycle and relation with arrhythmia termination
Key result
Administration of class 1C drugs (flecainide or propafenone) restored sinus rhythm in all patients by significantly increasing the mean fibrillation interval to an average of 295 ms.
Why the study?
Do class 1C drugs (flecainide or propafenone) alter the mean fibrillation interval and facilitate arrhythmia termination in patients with lone paroxysmal atrial fibrillation?
Population
10 patients with lone paroxysmal atrial fibrillation
Comparison
Class 1C drug administration and isoprenaline… vs Basal conditions (before drug administration)
Design
Cohort
Follow-up
within 10 minutes
Authors
Discussion
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Implication
May support class Ic use for rhythm restoration in lone paroxysmal AF; leaves open risks of 1:1 AV conduction with adrenergic stimulation.
Study Design
Type
Observational (n=10)
Multicenter
No
Structured PICO
Do class 1C drugs (flecainide or propafenone) alter the mean fibrillation interval and facilitate arrhythmia termination in patients with lone paroxysmal atrial fibrillation?
P
Population
10 patients with lone paroxysmal atrial fibrillation
I
Intervention
Class 1C drug administration (flecainide or propafenone 2 mg/kg) and isoprenaline infusion
C
Comparator
Basal conditions (before drug administration)
O
Outcome
Dynamic behaviour of MFF (the mean of 100 consecutive atrial fibrillation intervals) at two atrial sitessurrogate
Main Result
Absolute Event Rate: 295% vs 177%
Class 1C drugs effectively restore sinus rhythm by increasing the mean fibrillation interval, but adrenergic stimulation during treatment can provoke dangerous 1:1 AV conduction with rapid ventricular rates.
Cite This Study
Biffi et al. (1999) conducted an observational in lone paroxysmal atrial fibrillation (n=10). Class 1C drugs (flecainide or propafenone) and isoprenaline vs. Baseline was evaluated on Mean fibrillation interval (MFF). Administration of class 1C drugs (flecainide or propafenone) restored sinus rhythm in all patients by significantly increasing the mean fibrillation interval to an average of 295 ms.