Key result
Oral propafenone therapy for supraventricular tachyarrhythmias resulted in at least one adverse reaction in 59% of patients, with 15% discontinuing therapy due to an adverse drug reaction.
Why the study?
Is long-term oral propafenone therapy safe and well-tolerated in patients with supraventricular tachyarrhythmias?
Cohort (n=480)
Is long-term oral propafenone therapy safe and well-tolerated in patients with supraventricular tachyarrhythmias?
Long-term oral propafenone for supraventricular arrhythmias is generally well tolerated, though cardiovascular toxicity is more frequent in patients with underlying structural heart disease.
May warrant closer monitoring for adverse reactions with propafenone in SVT; leaves open long-term safety questions in broader populations.
An important issue regarding the long-term use of antiarrhythmic drugs concerns the safety of these agents, particularly with regard to cardiac toxicity. Propafenone is an effective drug for preventing supraventricular tachyarrhythmia, but the incidence of side effects during longterm therapy in patients with such arrhythmias has not been adequately reported. A total of 480 patients received oral propafenone as therapy for symptomatic atrial fibrillation, atrial flutter, or supraventricular tachycardia. During the follow-up (mean 14.4 months), 290 patients (60%) discontinued propafenone therapy, but in only 70 patients (15%) was the reason for discontinuation an adverse drug reaction. Overall, 284 patients (59%) experienced at least 1 adverse reaction, and the incidence was related to dose and age >65 years. The overall incidence of side effects was not related to structural heart disease; however, cardiovascular toxicity including arrhythmia aggravation, congestive heart failure, and serious conduction disturbances occurred more often in those with heart disease (20% vs 13%). Sixteen patients died during drug therapy, but in only 1 case was the drug considered contributory. For patients with a supraventricular arrhythmia, propafenone was well tolerated and was infrequently discontinued because of side effects. The incidence of serious cardiac toxicity when propafenone was used to treat supraventricular arrhythmia was low, and these side effects were more frequent in patients with structural heart disease.
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Podrid et al. (1996) conducted a cohort in symptomatic atrial fibrillation, atrial flutter, or supraventricular tachycardia (n=480). Oral propafenone was evaluated on at least 1 adverse reaction. Oral propafenone therapy for supraventricular tachyarrhythmias resulted in at least one adverse reaction in 59% of patients, with 15% discontinuing therapy due to an adverse drug reaction.
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