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 .
Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation. Results of a randomized, double-blind, controlled study.
AIMS To evaluate the efficacy and safety of a single loading oral dose of propafenone in the interruption of recent-onset atrial fibrillation . METHODS After a complete medical history , physical examination , 12-lead ECG , chest X-ray , and routine biochemical laboratory testing , 55 consecutive patients with recent-onset atrial fibrillation were r and omized double-blind in the emergency department for the administration of either a single oral dose ( 450 to 750 mg ) of propafenone ( 29 cases ) or a placebo ( 26 cases ) . After the 24-h observation period , comprehensive echocardiographic examination was performed . RESULTS The groups were homogeneous as regards biological , clinical and echocardiographic characteristics . Two hours after treatment , 12 patients ( 41 % ) on propafenone but only two ( 8 % ) on placebo had converted to sinus rhythm ( P = 0.005 ) . This striking difference was maintained 6 h after treatment ( 65 vs 31 % ; P = 0.015 ) but lessened at 12 h ( 69 % vs 42 % ; P = 0.060 ) and was insignificant at the end of the 24-h treatment period ( 79 % , vs 73 % ; P = 0.752 ) . Apart from hypotension , transient in three cases and sustained in one whose later echocardiographic examination demonstrated left systolic ventricular dysfunction , propafenone was well tolerated . CONCLUSION Although there is no significant difference in the rates of conversion 24 h after treatment , propafenone works faster than placebo in achieving sinus rhythm . This rapid action of oral propafenone can be useful to solve quickly the clinical problems of a high proportion of patients arriving at the emergency department with acute atrial fibrillation
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 .