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 .
Randomized, crossover, controlled comparison of oral loading versus intravenous infusion of propafenone in recent-onset atrial fibrillation.
A population of 123 patients with recent-onset ( < 72 hours ) atrial fibrillation ( AF ) without heart failure was r and omly treated with propafenone ( PFN ) intravenously ( i.v . ) ( 2 mg/kg bolus followed by 0.0078 mg/kg/min infusion ) or in a single oral dose ( o.s . ) ( 600 mg ) , or with placebo ( PLA ) ( phase 1 ) . If AF persisted 8 hours later , patients on active drugs received the alternative formulation ( crossover ) , and patients receiving PLA remained on PLA ( phase 2 ) . A 24-hour Holter monitoring was performed and conversion to sinus rhythm ( SR ) at 1 , 4 , and 8 hours of each phase was used as the criterion of efficacy . Conversion to SR occurred within 1 hour in 48 % of patients with i.v.-PFN , 15 % with o.s.-PFN , and in 17 % with PLA ( both P < 0.05 vs i.v.-PFN ) . Oral PFN was superior to PLA at 4 hours ( 71 % vs 33 % , P = 0.001 ) and 8 hours ( 78 % vs 48 % , P < 0.01 ) , and 1 at 8 hours also superior to i.v.-PFN ( 53 % , P < 0.03 ) . The mean conversion time within 4 hours was shorter with i.v.-PFN ( 25 + /- 15 ' ) than with o.s.-PFN ( 167 + /- 166 ' , P < 0.001 ) or with PLA ( 156 + /- 107 ' , P < 0.001 ) . The rates of conversion to SR with i.v.-PFN after o.s.-PFN failure were comparable to PLA at any observation time , whereas nonresponders to i.v.-PFN who received o.s.-PFN had significantly higher conversion rates than with placebo at both 4 hours ( 65 % vs 19 % ) and 8 hours ( 76 % vs 24 % ; both P < 0.045 ) . Neither serious adverse effects nor episodes of regular tachycardia with 1:1 AV conduction were noted . PFN administered intravenously or in a single oral loading dose was safe and efficacious in converting recent-onset AF to SR . The rates of conversion were different with different routes of administration : i.v.-PFN was superior to o.s.-PFN over a short observation period , while the overall efficacy of o.s.-PFN was superior at 8 hours
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 .