Abstract
Objective: Sinusa rhythm maintenance while using IC class medications is not practically studied. IC class medications aethacizinum is widely used, but has no large studies proving safety and efficacy. The aim of this study was to compare the efficacy of class IC antiarrhythmic medications, for sinus rhythm maintenance, after ECV (electrical cardioversion), in patients with atrial fibrillation (AF). Design and method: It is an open-label, one-center prospective study that held in the Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital from September 2019 to June 2020. Before hospitalisation patients have not received any antiarrhythmic drugs except of amiodarone and beta blockers. Patients with persistent form of AF received beta blockers (bisoprolol 5 mg daily), amiodarone (200 mg daily), propaphenone (300 mg daily) or aethacizinum (100 mg daily) for 6 months after conversion to sinus rhytm by ECV. Rest ECG, Holter monitoring, echocardiography, ergometer stress test, blood tests were performed. Results: The total number of patients finished study per protocol – n = 52. On echocardiographical study no significant changes in AFR (AF paroxysm group) and MSR (maintained sinus rhythm) groups were found. No safety parameters were significantly changed in this group. All patients were followed up for 6-month period. Reccurance rate of AF in aethacizinum group showed a statistically significant superiority compared to propafenone (55,6% vs 72,5%) (p = 0,05). Patients with higher atrial strain and strain rate appear to have a greater likelihood of staying in sinus rhythm. In our research, duration of AF was not predictive value of maintenance of SR at follow-up after 6 months from ECV. Conclusions: Antiarrhythmic medications of Ic class may be safe in patients with persistent form of atrial fibrillation and have no negative impact on inotropic function of myocardium. The most commonly used drug from Ic class ir etacizin. The observed efficacy provides the rationale for a larger, double-blind controlled study with different antiarrhythmic medications in different daily dosage.
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