No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .
Efficacy of propafenone for maintaining sinus rhythm in patients with recent onset or persistent atrial fibrillation after conversion: a randomized, placebo-controlled study
Objective — The aim of this study was to investigate the efficacy and safety of propafenone in the prevention of  atrial fibrillation ( AF ) relapse after restoration of sinus rhythm . Methods — This study consisted of 110 consecutive patients with recent onset and persistent AF . After restoration of sinus rhythm , patients were r and omized to propafenone ( n : 58 , age : 60 ± 12 years ) or placebo ( n : 52 , age : 62 ± 10 years).There were 11 withdrawals ( 7 in the propafenone and 4 in the placebo group ) during follow-up . Follow-up evalutations were conducted at the first , 3rd and then at an interval of three months during 15 months . The clinical characteristics in both groups were comparable . The AF relapse was analysed by the Kaplan-Meier method . Results — At 15-month follow-up , AF relapsed in 20 ( 39 % ) and 31 ( 65 % ) patients in the propafenone and placebo groups , respectively ( p = 0.015 ) . In subgroup analysis , AF recurrence was significantly lower in the propafenone group than in the placebo group only in the recent onset AF patients with spontaneous conversion ( 21 % vs. 61 % , p = 0.01 ) . However , the AF relapse rates were similar in patients with persistent AF and with recent AF who converted to sinus rhythm pharmacologically or electrically in the propafenone and placebo groups . Four patients on propafenone and one on placebo  had adverse effects necessitating discontinuation of the drug ( p = 0.36 ) . Conclusion — At 15 months , propafenone seems to be superior to placebo for maintaining sinus rhythm in patients with recent onset or peristent AF . This superiority originates mainly from patients with recent onset AF in whom sinus rhythm occurred spontaneously . Its adverse effects are similar to placebo . ( Acta Cardiol 2004 ; 59(3 ) : 255 - 261
No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .