Propafenone versus procainamide for conversion of atrial fibrillation to sinus rhythm.
OBJECTIVE
Antiarrhythmic drugs are widely used for treatment of atrial fibrillation (AF) and restoration of sinus rhythm. This prospective, randomized, and controlled study compared the efficiency and safety of propafenone versus procainamide for the treatment of acute AF.


METHODS
In all, 117 patients (55 women, 62 men, mean age 64.2 +/- 13 years, median 63 years) who presented with AF were included in the study. Exclusion criteria were signs or symptoms of heart failure on physical examination, recent myocardial infarction or cardiac surgery, cardiogenic shock, or hypotension. Forty-one patients spontaneously recovered sinus rhythm; the remaining 76 patients were randomized to receive propafenone or procainamide. Propafenone was given at a dose of 2 mg/kg body weight intravenously (i.v.) over 30 min. Patients randomized to receive procainamide received a bolus of 100 mg i.v. administered every 5 min up to a maximum dose of 1 g. The clinical characteristics of the two groups were comparable.


RESULTS
The number of patients who recovered sinus rhythm after the treatment was larger in the procainamide-treated group (Group 1) (69.5%) than in the propafenone-treated group (Group 2) (48.7%); p < 0.05. The time required for cardioversion was significantly lower in Group 1 (mean 4.1 +/- 1.3 h), than in Group 2 patients (mean 7.3 +/- 2.6 h) (p < 0.01).


CONCLUSIONS
In the present study, procainamide was more effective than propafenone for the treatment of AF of short duration.
Mattioli
A V
AV
Department of Cardiology, Internal Medicine, University of Modena, Italy.
Lucchi
G R
GR
Vivoli
D
D
Mattioli
G
G
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy*; D004361:Drug Tolerance; D005260:Female; D006801:Humans; D007262:Infusions, Intravenous; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D011342:Procainamide / Q000008:administration & dosage / Q000627:therapeutic use*; D011405:Propafenone / Q000008:administration & dosage / Q000627:therapeutic use*; D013997:Time Factors
D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D011342:Procainamide