Key result
Oral propafenone achieved a similar rate of conversion to sinus rhythm compared to intravenous amiodarone (85% vs 83%) but significantly reduced the time to conversion (3.9 vs 9.1 hours) in patients with recent onset atrial fibrillation.
Why the study?
Atrial fibrillation is common and multiple antiarrhythmic agents restore sinus rhythm, but the efficacy and rapidity of oral propafenone compared with intravenous amiodarone needed evaluation.
Does oral propafenone improve the efficacy and speed of conversion to sinus rhythm in patients with recent onset atrial fibrillation compared to intravenous amiodarone?
RCT (n=200)
Open-label
Closed envelope method
Yes
Does oral propafenone improve the efficacy and speed of conversion to sinus rhythm in patients with recent onset atrial fibrillation compared to intravenous amiodarone?
Oral propafenone is faster than intravenous amiodarone for the conversion of recent onset atrial fibrillation to sinus rhythm, with similar overall efficacy.
Oral propafenone may accelerate recent-onset AF conversion; leaves open whether to prefer it over IV amiodarone.
BACKGROUND: Atrial fibrillation is the most commonly encountered arrhythmia. Several antiarrhythmic agents are effective in restoring and maintaining sinus rhythm. AIM OF THE WORK: To compare the efficacy and rapidity of conversion of recent onset atrial fibrillation using oral propafenone versus intravenous infusion of amiodarone. METHODS: The study included 200 patients with recent onset atrial fibrillation. Patients were equally divided into 2 groups; group A where intravenous infusion amiodarone was given and group B where oral propafenone was administrated. The effectiveness and the time needed for conversion of atrial fibrillation to sinus rhythm were compared in both groups. RESULTS: The success of conversion of atrial fibrillation to sinus rhythm was 83% in group A and 85% in group B, p-value = 0.699. The time elapsed from drug administration till conversion of atrial fibrillation was 9.07 ± 5.04 hours in group A versus 3.9 ± 1.54 hours in group B, p-value = 0.001. In both groups, patients who showed failed conversion had a significantly larger left atrial diameter and a significantly higher high sensitivity C-reactive protein (hsCRP) level. CONCLUSION: Oral propafenone was faster than parenteral amiodarone in the conversion of recent onset atrial fibrillation to sinus rhythm. Patients with failed conversion had a bigger left atrial diameter and a higher hsCRP when compared to patients with successful conversion.
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Taha et al. (2022) conducted an RCT in Recent onset atrial fibrillation (n=200). Oral propafenone vs. Intravenous amiodarone was evaluated on Success of conversion of atrial fibrillation to sinus rhythm within 24 hours (p=0.699). Oral propafenone achieved a similar rate of conversion to sinus rhythm compared to intravenous amiodarone (85% vs 83%) but significantly reduced the time to conversion (3.9 vs 9.1 hours) in patients with recent onset atrial fibrillation.
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