Key result
Propafenone did not significantly reduce early atrial tachyarrhythmia recurrences compared to placebo (53.4% vs 61.1%, p=0.11) after pulmonary vein isolation, despite reducing episode frequency.
Why the study?
Does propafenone prevent early postoperative atrial tachyarrhythmias and reduce the need for hospitalization or cardioversion in patients with paroxysmal AF undergoing radiofrequency ablation of pulmonary veins?
RCT (n=112)
Placebo-controlled
Envelope method
No
Does propafenone prevent early postoperative atrial tachyarrhythmias and reduce the need for hospitalization or cardioversion in patients with paroxysmal AF undergoing radiofrequency ablation of pulmonary veins?
Short-term use of propafenone in the early postoperative blanking period after pulmonary vein isolation safely reduces early atrial tachyarrhythmia recurrences and the subsequent need for hospitalization or cardioversion.
Answers are grounded in this paper and cite their sources.
Propafenone may reduce early post-PVI interventions; leaves open routine use pending randomized data.
Currently pulmonary veins isolation becomes one of the approaches for invasive treatment of paroxysmal atrial fibrillation (AF). One of difficult and unexplored problems associated with this procedure is management of patients in postoperative period (especially early) which is often complicated by frequent early recurrence of atrial tachyarrhythmias. The purpose of this study was to assess effectiveness and safety of IC antiarrhythmic drug propafenone for prevention of arrhythmia recurrence in the early postoperative period compared with placebo. Taking into account the inclusion and exclusion criteria 120 patients with paroxysmal AF were included and randomized and underwent radiofrequency ablation of pulmonary veins; 112 patients successfully finished the study. More than 57% of patients had early postoperative atrial tachyarrhythmias (AT) most of which were new and regular. Reduction of incidence of post-ablation AT during blanking period in propafenone group was clinically significant what was confirmed by patient’s diary and ECG-monitoring. Propafenone treatment within this period reduce the need for hospitalization or cardioversion without putting patient at risk of serious side effects associated with its prolonged use.
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Tarasov et al. (2015) conducted an RCT in Paroxysmal atrial fibrillation (n=112). Propafenone vs. Placebo was evaluated on Recurrence of atrial tachyarrhythmias (AF, atrial flutter, atrial tachycardia) lasting >30 seconds within 3 months (p=0.11). Propafenone did not significantly reduce early atrial tachyarrhythmia recurrences compared to placebo (53.4% vs 61.1%, p=0.11) after pulmonary vein isolation, despite reducing episode frequency.
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