[Efficacy of pilsicainide for the long-term prevention of paroxysmal atrial fibrillation: analysis based on the time of onset].
OBJECTIVE
This study evaluated the efficacy of long-term pilsicainide therapy to maintain sinus rhythm in patients with paroxysmal atrial fibrillation in terms of the time of onset.


METHODS
A total of 81 patients (57 men, 24 women, mean age 65 +/- 11 years) were given pilsicainide (150 mg/day) after cardioversion. Paroxysmal atrial fibrillation was divided into three types by the time of onset: the day type (AM 7:00-PM 5:00, n = 13), the night type (PM 5:00-AM 7:00, n = 12) and the mixed type (n = 56). Mean follow-up period was 35.4 +/- 16.1 months.


RESULTS
There was a higher incidence of hypertension in the day type (38.5%) and the mixed type (48.2%) than in the night type (8.3%) (p < 0.05). The periods for maintenance of sinus rhythm in the day type, the night type and the mixed type were 15.7 +/- 5.0, 9.9 +/- 2.7 and 5.7 +/- 1.3 months, respectively, with a significant difference between the day type and the mixed type (p < 0.01). Actuarial event free-rates at 1, 3, 6, 9 and 12 months were 76.9%, 69.2%, 61.5%, 53.8% and 53.8% respectively, in the day type, 83.3%, 66.7%, 58.3%, 33.3% and 33.3%, respectively, in the night type and 58.9%, 37.5%, 26.8%, 25.0% and 21.4%, respectively, in the mixed type. There was a significant difference in the rate at 12 months between the day type and the mixed type (p < 0.05).


CONCLUSIONS
These results suggest that pilsicainide has a high degree of efficacy for maintaining normal sinus rhythm in patients with the day type onset of paroxysmal atrial fibrillation.
Komatsu
T
T
Division of Cardiology, Department of Internal Medicine, Iwate Prefectural Iwai Hospital, Maeda 13, Yamanome, Ichinoseki, Iwate 021-0015.
Nakamura
S
S
Kimura
M
M
Owada
S
S
Tomita
H
H
Yomogida
K
K
Okumura
K
K
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000517:prevention & control*; D004554:Electric Countershock; D005260:Female; D006801:Humans; D006973:Hypertension / Q000209:etiology; D008012:Lidocaine / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D013995:Time
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide