Key result
Propafenone reduced the number of pharmacological cardioversions compared to verapamil (8.62 vs 13.24, p=0.013) in the early postoperative period after pulmonary vein isolation.
Why the study?
Does propafenone, sotalol, or verapamil reduce the recurrence of atrial tachyarrhythmias and associated interventions in patients with paroxysmal AF after pulmonary vein isolation?
RCT (n=243)
Open-label
randomized
Does propafenone, sotalol, or verapamil reduce the recurrence of atrial tachyarrhythmias and associated interventions in patients with paroxysmal AF after pulmonary vein isolation?
Absolute Event Rate: 8.62% vs 13.24%
p-value: p=0.013
Propafenone demonstrated better clinical effectiveness than verapamil or sotalol for preventing atrial tachyarrhythmia recurrences and associated interventions in the early postoperative period after pulmonary vein isolation.
Propafenone may be preferred over verapamil to reduce early post-PVI interventions; extends RCT evidence guiding antiarrhythmic choice after ablation.
. Aim. To study the effectiveness of antiarrhythmic drugs: propafenone, sotalol and verapamil for the prevention of recurrence of atrial fibrillation (AF) and other atrial tachyarrhythmias in the early postoperative period after pulmonary vein ostia catheter isolation in patients with paroxysmal AF. Material and methods. Patients (n=243) were included into a prospective, comparative, open-label, randomized study with a control. They were divided into 4 groups: Patients of Group 1 (n=61) received verapamil retard 240 mg/day., Group 2 (n=62) – propafenone 450 mg/day, group 3 (n=60) – sotalol 160 mg/day. Patients of control Group 4 (n=60) did not receive antiarrhythmic drugs. Patient's diary, ECG, 24-hour Holter ECG monitoring, and percutaneous heart monitor were used to detect arrhythmias in the early postoperative period. Results. During the first 3 months of postoperative period we registered 8.62±9.37 pharmacological cardioversions in Group 2, 13.24±10.77 in Group 1 (p=0.013), and 11.93±12.02 in Group 3 (p=0.123). Besides we performed 0.40±1.03 electrical cardioversions in Group 2, 1.016±1.74 in Group 1 (p=0.024), and 1.033±1.52 in Group 3 (p=0.0096). A number of hospitalizations was 0.447±0.57 in Group 2, 0.684±0.73 in Group 1 (p=0.0012), and 0.592±0.67 in Group 3 (p=0.074). Conclusion. Better clinical effectiveness for prevention of atrial tachyarrhythmias recurrence in the early postoperative period was found in the propafenone group.
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Tarasov et al. (2017) conducted an RCT in Paroxysmal atrial fibrillation (n=243). Propafenone vs. Verapamil, sotalol, or no antiarrhythmic drugs was evaluated on Number of pharmacological cardioversions (p=0.013). Propafenone reduced the number of pharmacological cardioversions compared to verapamil (8.62 vs 13.24, p=0.013) in the early postoperative period after pulmonary vein isolation.
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