Propafenone was of approximately equal efficacy to atenolol in preventing postcardiotomy SVT, with events occurring in 12.4% vs 10.8% of patients (P=0.89).
RCT (n=207)
Double-blind
Randomized
Absolute Event Rate: 12.4% vs 10.8%
p-value: p=0.89
To compare the efficacy of propafenone to atenolol in the prevention of supraventricular tachyarrhythmias (SVT) following cardiac surgery, 207 consecutive patients were randomly allocated to receive either propafenone 300 mg twice daily (105 patients) or atenolol 50 mg once daily (102 patients) orally for 7 days after operation. Double blinding was achieved using placebos. The end point was the development of a SVT which was symptomatic, recurrent, or lasting over 2 minutes, or the occurrence of adverse effects possibly attributable to the drugs. The groups were well matched for age, sex, bypass- and cross-clamp times, and other data. Thirteen patients in the propafenone group and 11 in the atenolol group developed SVT during the first week after operation. (P = 0.89, non significant, chi-squared with Yates' correction). In our study propafenone and atenolol were of approximately equal efficacy in preventing post cardiotomy SVT. Propafenone may have an advantage in being less negatively inotropic than atenolol; it could therefore be used in patients with poor left ventricular function or marginal haemodynamics when a beta blocker is contraindicated.
Merrick et al. (Sun,) conducted a rct in Supraventricular tachyarrhythmias following cardiac surgery (n=207). Propafenone vs. Atenolol 50 mg once daily orally was evaluated on Development of a SVT which was symptomatic, recurrent, or lasting over 2 minutes, or the occurrence of adverse effects possibly attributable to the drugs (p=0.89). Propafenone was of approximately equal efficacy to atenolol in preventing postcardiotomy SVT, with events occurring in 12.4% vs 10.8% of patients (P=0.89).