[Comparison of the efficacies of disopyramide, cibenzoline and aprindine for the termination of paroxysmal and persistent atrial fibrillation in elderly and non-elderly patients].
OBJECTIVE
The relationship between the efficacy of the anticholinergic action of disopyramide, cibenzoline and aprindine and age was examined in patients with paroxysmal and persistent atrial fibrillation.


METHODS
This prospective, randomized study included 278 patients (200 men, 78 women, mean age 61 +/- 11 years) divided into two groups; the non-elderly group (age below 60 years) and the elderly group (age over 60 years). Successful termination was defined as conversion of sinus rhythm within 30 min of intravenous administration of 50 mg disopyramide (n = 91), 70 mg cibenzoline (n = 93) or 100 mg aprindine (n = 94) in this prospective and randomized study.


RESULTS
No statistically significant difference was found in patient characteristics between the three agents. 1) The rate of conversion to sinus rhythm after disopyramide administration in the non-elderly group(37.8%) was significantly higher than that in the elderly group (17.4%, p = 0.0361). 2) The rate of conversion to sinus rhythm after cibenzoline administration in the non-elderly group (62.2%) tended to be greater than that in the elderly group (43.8%, p = 0.0972). 3) The rate of conversion to sinus rhythm after aprindine administration in the non-elderly group (25.6%) was not significantly higher than that in the elderly group (18.2%, p = 0.4474).


CONCLUSIONS
The anticholinergic action of antiarrhythmic agents has an effect on successful termination in non-elderly patients with paroxysmal and persistent atrial fibrillation.
Komatsu
Takashi
T
Division of Cardiology, Department of Internal Medicine, Iwate Prefectural Iwai Hospital, Maeda 13, Yamanome, Ichinoseki, Iwate 021-8533.
Nakamura
Shin
S
Suzuki
Osamu
O
Yomogida
Kunihiko
K
Horiuchi
Daisuke
D
Abe
Naoki
N
Kameda
Kunihiko
K
Owada
Shingen
S
Tomita
Hirofumi
H
Oikawa
Koichi
K
Okumura
Ken
K
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001073:Aprindine / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D001341:Autonomic Nervous System / Q000503:physiopathology; D002940:Circadian Rhythm; D004206:Disopyramide / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007093:Imidazoles / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000889:Anti-Arrhythmia Agents; D007093:Imidazoles; D001073:Aprindine; D004206:Disopyramide; C032151:cifenline