[Fibrillation and atrial flutter. Immediate control and conversion to sinus rhythm with intravenous propafenone].
The safety and efficacy of intravenous Propafenone, in the treatment of atrial fibrillation (a.f.) or flutter (A.F.) of recent onset (15 days), were assessed. Propafenone (2 mg/kg) was administered to 36 consecutive patients (mean age 60.8 years), 28 with a.f. and 8 with A.F. Nineteen patients (52.7%) reverted to sinus rhythm within 85 min (mean 27.2 min): 17 of 28 (60.7%) with a.f. and 2 of 8 (25%) with A.F. The efficacy of the drug was significantly influenced by the time elapsed from the onset of the arrhythmia: 14/21 (66.6%) patients with the arrhythmia lasting less then 48 hours and only 5/15 (33.3%) of those with the arrhythmia lasting more than 48 hours or of unknown onset, were converted (p less than 0.05). 18 patients underwent echocardiographic control: mean left atrial dimensions were 41.4 +/- 11.4 mm in converters and 47.4 +/- 11.2 mm in non converters (p = NS). Mean QRS lengthening observed was 16% (from 89 +/- 35.1 to 103.5 +/- 48.8 msec) (p = NS); QTc interval increased from 390 +/- 64.3 to 403 +/- 36.2 msec (p = NS). Arterial blood pressure showed significant changes only in two patients in whom a serious hypotension developed, needing infusion of adrenergic drugs. Non converters showed a reduction of the ventricular rate from 141.8 +/- 29.4/min to 101.8 +/- 18/min (p less than 0.01) meanwhile the shortest RR interval increased from 359.5 +/- 60.8 to 450 +/- 81.5 msec (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)
Divisione di Cardiologia, Ospedale S. Filippo Neri, Roma.
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Bianconi
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Boccadamo
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Pappalardo
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Broglia
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Pistolese
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D001282:Atrial Flutter / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011405:Propafenone / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*
D011405:Propafenone
Fibrillazione e flutter atriale. Controllo immediato e conversione a ritmo sinusale con propafenone endovena.