What question did this study set out to answer?

To compare the safety and efficacy of intravenous amiodarone and propafenone for converting postoperative atrial fibrillation or flutter following cardiac surgery.

January 1, 1995European Journal of Cardio-Thoracic Surgery

Intravenous amiodarone vs propafenone for atrial fibrillation and flutter after cardiac operation

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Why the study?

Does intravenous amiodarone compared to propafenone improve conversion to sinus rhythm in patients with postoperative atrial fibrillation or flutter?

Population

84 patients with sustained atrial tachyarrhythmias of more than 30 minutes duration after cardiac surgery…

Comparison

Intravenous amiodarone vs Intravenous propafenone

Design

RCT, randomized, double-blind

Follow-up

24 hours

Authors

RSRoberto ScrofaniInterventional / Structural Cardiology APAntonella PajèLuigi Sacco Hospital ECE. CappielloFederico II University Hospital

Discussion

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Implication

Propafenone enables faster initial conversion than amiodarone in postoperative AF; extends RCT evidence on time-specific antiarrhythmic efficacy.

Key Points

To compare the safety and efficacy of intravenous amiodarone and propafenone for converting postoperative atrial fibrillation or flutter following cardiac surgery.
Randomized double-blind trial evaluating 84 hemodynamically stable patients with sustained postoperative atrial tachyarrhythmias (>30 minutes) without prior arrhythmias or antiarrhythmic therapy.
Patients received intravenous amiodarone (N=46; 5 mg/kg over 15 min, followed by 15 mg/kg over 24 h if unconverted) or propafenone (N=38; 2 mg/kg over 15 min, followed by 10 mg/kg over 24 h if unconverted).
Propafenone achieved a significantly higher conversion rate to sinus rhythm within 1 hour post-bolus compared to amiodarone (44.7% [17/38] vs 19.5% [9/46], P < 0.05).
Cumulative 24-hour conversion rates reached 82.6% (38/46) for amiodarone and 68.4% (26/38) for propafenone (P = NS), with both agents demonstrating significant ventricular rate reduction by 10 minutes.
Adverse effects occurred in 15.7% (6/38) of propafenone-treated patients and 10.8% (5/46) of amiodarone-treated patients (P = NS).

Structured PICO

Does intravenous amiodarone compared to propafenone improve conversion to sinus rhythm in patients with postoperative atrial fibrillation or flutter?

Population

84 patients with sustained atrial tachyarrhythmias (atrial fibrillation or flutter) of more than 30 minutes duration after cardiac surgery, with stable hemodynamic status and neither preoperative atrial arrhythmias nor treatment with other antiarrhythmic drugs

Intervention

Intravenous amiodarone (5 mg/kg over 15 min, then 15 mg/kg over the subsequent 24 h for non-converting)

Comparator

Intravenous propafenone (2 mg/kg over 15 min, then 10 mg/kg over the subsequent 24 h for non-converting)

Outcome

Conversion to sinus rhythm within 1 hour and 24 hours

Intravenous propafenone achieves faster conversion to sinus rhythm than amiodarone in the first hour for postoperative atrial fibrillation/flutter, though both are equally effective at 24 hours.

Cite This Study

Scrofani et al. (1995) studied this question.

synapsesocial.com/papers/6a85aca7f047f857d83dbd69 https://doi.org/10.1016/s1010-7940(05)80011-9

Topics

Persistent AF management Atrial fibrillation Valvular heart disease AF ablation outcomes Anticoagulation in AF

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Implication

Propafenone enables faster initial conversion than amiodarone in postoperative AF; extends RCT evidence on time-specific antiarrhythmic efficacy.

Intravenous amiodarone vs propafenone for atrial fibrillation and flutter after cardiac operation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Intravenous amiodarone vs propafenone for atrial fibrillation and flutter after cardiac operation

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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