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 to sinus rhythm: effects of different drug protocols.
UNLABELLED In a population of 417 hospitalized patients , the efficacy and safety of different drug regimens administered to convert atrial fibrillation ( AF ) of recent onset ( < or = 7 days duration ) to sinus rhythm were evaluated . All patients were in NYHA Class < or = 2 , and free of heart failure . They were r and omly allocated to treatment with placebo in 121 patients ; i.v . amiodarone , 5 mg/kg bolus , followed by 1.8 g/24 hours in 51 patients ; i.v . propafenone , 2 mg/kg bolus , followed by 0.0078 mg/kg/min in 57 patients ; p.o . propafenone , 600 mg p.o . in a single dose in 119 patients ; and p.o . flecainide , 300 mg p.o . in a single dose in 69 patients . All patients were continuously monitored by  Holter ECG  , and the number of conversions to sinus rhythm was measured at 1 , 3 , and 8 hours . RESULTS ( 1 ) I.v . propafenone result ed in a higher conversion rate within 1 hour compared with the oral loading regimens of propafenone or flecainide , but the conversion rates at 3 and 8 hours were comparable , approximately 75 % at 8 hours ; 2 ) i.v . amiodarone was not different from placebo until 8 hours when it was associated with 57 % of conversions ; ( 3 ) conversion to sinus rhythm at 8 hours was observed in 37 % of the placebo treated patients . Serious adverse effects occurred in few patients : two patients treated with flecainide and one treated with i.v . propafenone experienced left ventricular decompensation ; one patient treated with placebo and two treated with flecainide had atrial flutter with rapid ventricular response . In conclusion , single-dose , oral loading with propafenone or flecainide are acceptable alternatives to conventional drug regimens in selected hospitalized patients . In addition , the measure of a placebo effect is m and atory in studies of recent-onset AF
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 .