Key result
Intravenous propafenone significantly increased the restoration of sinus rhythm compared to placebo (90.8% vs 32.1%, p < 0.0005) in patients with recent-onset atrial fibrillation.
Why the study?
Does intravenous propafenone improve the restoration of sinus rhythm in patients with recent-onset atrial fibrillation lasting < 7 days?
RCT (n=182)
Double-blind
Does intravenous propafenone improve the restoration of sinus rhythm in patients with recent-onset atrial fibrillation lasting < 7 days?
Intravenous propafenone is highly effective and rapid for converting recent-onset atrial fibrillation to sinus rhythm, and it significantly reduces ventricular rate in those who do not convert.
Supports IV propafenone for recent-onset AF cardioversion; confirms superiority over placebo in this RCT.
To evaluate the efficacy of propafenone in converting recent-onset atrial fibrillation (AF) lasting < 7 days, 182 patients were treated intravenously with propafenone (Group 1, n = 98) and with placebo 0.9% saline solution (Group 2, n = 84) in a double blind study. The treatment was continued until sinus rhythm (SR) was restored, but for no more than 24 h. Eighty-nine patients treated with propafenone (90.8%) and 27 patients treated with placebo (32.1%) responded to the treatment and SR was restored (p < 0.0005). The mean time for SR restoration was 2.51 +/- 2.77 h in Group 1, and 17.15 +/- 7.8 h in Group 2 (p < 0.0005). In both groups the patients in whom SR was not restored (nonresponders) had larger left atrial size and longer duration of AF than responders at the onset of the arrhythmia. Nonresponders in Group 1 showed a decrease in mean ventricular rate (MVR) from 143 +/- 16 to 101 +/- 18 (p < 0.0005), while in the nonresponders in Group 2 no reduction of MVR was observed. Two patients whose SR was restored with propafenone had sinus standstill lasting 3.4 and 3.8 s, respectively. Propafenone used intravenously is an effective, quick, and safe drug for treating AF. Moreover, it significantly reduces MVR in nonresponders.
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Bellandi et al. (1995) conducted an RCT in Recent-onset atrial fibrillation (n=182). Intravenous propafenone vs. Placebo 0.9% saline solution was evaluated on Restoration of sinus rhythm (p=<0.0005). Intravenous propafenone significantly increased the restoration of sinus rhythm compared to placebo (90.8% vs 32.1%, p < 0.0005) in patients with recent-onset atrial fibrillation.
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