Pharmacological conversion of recent-onset atrial fibrillation: a randomized study of propafenone and amiodarone

Abstract

Aim The aim of this study was to compare the efficacy and rapidity of recent-onset atrial fibrillation (AF) conversion by oral propafenone versus an intravenous infusion of amiodarone. Background Amiodarone and propafenone are the most widely used drugs in Egypt for the pharmacological cardioversion of AF. Patients and methods Fifty patients with recent-onset AF – within less than 48 h – were investigated. The patients were divided randomly into two groups: the first group (group A) included 25 patients in whom amiodarone was administered and the second group (group B) included 25 patients in whom propafenone was administered. Results 88% of patients in group A were converted successfully into sinus rhythm compared with 84% of patients in group B (receiving propafenone). The time elapsed between the onset of drug administration to conversion of AF into sinus rhythm in group A was 9 h: 7 min ± 5 h: 04 min, whereas that of group B was 3 h: 9 min ± 1 h: 54 min, with P value 0.001 (highly significant). Conclusion Intravenous infusion of amiodarone as well as oral propafonone can be used successfully in cardioversion of AF into sinus rhythm. Intravenous infusions of amiodarone and oral propafonone are not only highly effective but also well-tolerated drugs in the management of recent-onset AF. Time needed for conversion of AF into sinus rhythm using oral propafenone is significantly shorter than that needed by amiodarone.