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2000, Number 2

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Arch Cardiol Mex 2000; 70 (2)

Intravenous propafenone for the conversion of atrial fibrillation

Velázquez RE, Cancino RC, Arias ES, Rangel RJ, Hernández ME, Uribe MA

Language: Spanish
References: 44
Page: 160-166
PDF size: 151.73 Kb.


ABSTRACT

The efficacy and safety of intravenous propafenone for conversion of recent-onset and chronic atrial fibrillation was assessed in 46 patients. 40 with atrial fibrillation associated with or without structural heart disease (mean age 63 ± 14 years) and 6 patients with atrial fibrillation related to the Wolff-Parkinson-White syndrome (mean age 34.8 ± 13 years). Propafenone treatment was administered at 2 mg/kg over 15 minutes under continuous electrocardiographic monitoring. In 28 of 32 (87.5%) patients with paroxysmal and/or recent-onset atrial fibrillation a stable sinus rhythm was restored within 1 hour after propafenone (mean 17 ± 11 minutes) and in only 3 of 8 (37.5%) with chronic atrial fibrillation (p ‹ 0.05). Conversion to sinus rhythm was obtained in 5 of 6 (83.3%) patients with atrial fibrillation related ventricular preexcitation, mean time 21 ± 12 minutes. Propafenone had an additional effect reducing mean heart rate (141 ± 21 to 102 ± 15 beat per minute, p ‹ 0.05) and the shortest preexcited R-R intervals was increased, mean 231.6 ± 27.8 to 355 ± 37.2 milliseconds (p‹ 0.001) in cases associated with ventricular preexcitation. Dizziness, hypotension and transient conduction disturbances occurred in only one patient with rheumatic valvular heart disease: EF 40%. Propafenone is an effective and safe antiarrhythmic drug for converting paroxysmal and/or recent-onset atrial fibrillation of various origins with a more limited efficacy in chronic atrial fibrillation.


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