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 .
[Effectiveness and side effects of the treatment with propafenone and flecainide for recent-onset atrial fibrillation].
BACKGROUND The authors report their experience in recent-onset atrial fibrillation treated with intravenous flecainide and propafenone , in comparison with the placebo group . METHODS We r and omized 352 ( 138 in the flecainide group , 164 in the propafenone group and 50 in the control group ) consecutive patients ( 167 males , 185 females , mean age 59 + /- 12 years ) with recent-onset atrial fibrillation . The  electrocardiogram  of all patients was monitored for at least 24 hours . RESULTS The restoration of sinus rhythm occurred in 72.5 , 80.4 , 86.2 and 89.8 % of patients in the flecainide group ; in 54.3 , 68.3 , 75 and 92.1 % in the propafenone group ; in 22.2 , 27.8 , 35.2 and 46.3 % in the control group , at 1 , 3 , 6 and 24 hours respectively . The occurrence of side effects was the same in all treatment groups , and occurred in about 10 % of patients in the flecainide and propafenone groups , and in 4 % in the control group . In our study population the treatment of recent-onset atrial fibrillation with flecainide was faster in converting the arrhythmia to sinus rhythm ( p < 0.005 at 1 hour , p < 0.05 at 3 hours , p = 0.05 at 6 hours ) . However within 24 hours the efficacy of either flecainide or propafenone was the same ( p = NS at 24 hours ) . CONCLUSIONS Side effects were similar in both treatment groups . In particular malignant arrhythmias did not occur in the treatment groups and in the control group
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 .