Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .
Conversion of recent onset atrial fibrillation with single loading oral dose of propafenone: is in-hospital admission absolutely necessary?
A population of 283 patients with recent onset ( < 72 hours ) AF , without heart failure , who received a single 450- or 600-mg oral dose of propafenone , or digoxin 1 mg , or placebo for conversion to sinus rhythm ( SR ) , was studied to determine whether a routine admission to the hospital for drug administration is justified . Previous bradyarrhythmias or sick sinus syndrome ( SSS ) , and concomitant use of antiarrhythmic drugs were exclusion criteria . None of the 283 patients studied experienced VT or VF and none of them needed implantation of a temporary pacemaker . Periods of atrial tachyarrhythmias with regularization of atrial waves and 1:1 AV conduction were observed in only two cases , both receiving placebo . No predictor of proarrhythmia was found among the clinical variables considered ( age , etiology , arrhythmia duration , atrial dimension , and blood potassium ) . No serious hemodynamic adverse effects were noted in either group . The rates of conversion to SR after 4 hours were : 80 ( 57 % ) of 141 patients who received propafenone and 35 ( 25 % ) of 142 patients who received digoxin or placebo ( P < 0.001 ) . Acute oral treatment with propafenone is simple and effective for the conversion of recent onset AF to SR in patients without clinical signs of heart failure . The routine admission of these patients to the hospital is not necessary . Home-based administration of oral propafenone to a selected group of patients could significantly increase the cost effectiveness of this treatment
Moreover all the anti-arrhythmic agents that are used in treatment of AF were potentially pro-arrhythmic especially in patients with coronary artery disease and structurally abnormal heart .
Although atrial fibrillation ( AF ) is the most common sustained arrhythmia seen during daily cardiovascular physician practice , its management remained a challenge for cardiology physician as there was no single anti-arrhythmic agents proved to be effective in converting atrial fibrillation and kept its effectiveness in maintaining sinus rhythm over long term .
Some of these drugs also have serious non cardiac side effects that limit its long term use in the management of atrial fibrillation .
Several new and investigational anti-arrhythmic agents are emerging but data supporting their effectiveness and safety are still limited .