Abstract
In a single-blind, randomized study, the effectiveness of propafenone and amiodarone for reversion of recent-onset (≤1 week) atrial fibrillation was compared in 61 consecutive patients (New York Heart Association functional class I and II). Thirty-one patients were treated with propafenone (2 mg/kg intravenously over 10 minutes followed by a continuous infusion of 0.007 mg/kg per minute) and 30 patients with amiodarone (5 mg/kg intravenously over 10 minutes followed by an infusion of 15 mg/kg per day). Drug efficacy was measured by rate of reversion to sinus rhythm within 1 hour after the start of drug infusion. At 1 hour, 13 patients reverted with propafenone treatment and 3 with amiodarone treatment (42% vs 10%, P < 0.02). Restoration of sinus rhythm within 24 hours was achieved in 27 patients receiving propafenone and in 24 receiving amiodarone (87% vs 80%, P = NS). The median time to conversion was shorter for propafenone than for amiodarone (90 minutes vs 450 minutes, P < 0.005). No major adverse effects occurred in either treatment group. In conclusion, propafenone, administered intravenously as a loading dose followed by a maintenance infusion, is effective in reverting recent-onset atrial fibrillation to sinus rhythm and works faster than intravenous amiodarone. Both treatments were safe in patients without clinical evidence of heart failure.
Published Version
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