[Factors for successful conversion of atrial fibrillation using intravenous injection of pilsicainide hydrochloride].
OBJECTIVE
The factors affecting successful conversion of atrial fibrillation using intravenous injection of pilsicainide hydrochloride are unclear. The efficacy of intravenous injection of pilsicainide hydrochloride and the factors affecting successful conversion of symptomatic atrial fibrillation were investigated.


METHODS
Twenty-six patients[21 men, 5 women, 64 +/- 12 years (mean +/- SD)] with electrocardiographically confirmed, symptomatic atrial fibrillation were treated with intravenous injection 1.0 mg/kg of pilsicainide hydrochloride between October 31, 2000 and February 17, 2003. Successful conversion was defined as termination of atrial fibrillation within 30 min of intravenous injection. Before the injection of pilsicainide hydrochloride, blood pressure, conventional electrocardiography, chest radiography, echocardiography and blood examinations were performed. During and after injection of pilsicainide hydrochloride, blood pressure and conventional electrocardiography were monitored. After injection of pilsicainide hydrochloride, blood examinations were performed.


RESULTS
Pharmacological conversion to sinus rhythm was achieved in 7 of 26 patients(27%). The successful conversion group and unsuccessful conversion group showed significant differences in duration of atrial fibrillation(61 +/- 122 vs 12,257 +/- 25,959 hr, p < 0.01), heart rates before injection of pilsicainide (110 +/- 26 vs 87 +/- 26 beats/min, p < 0.05), cardiothoracic ratio(47.8 +/- 2.6% vs 53.5 +/- 5.1%, p < 0.01) and left atrial dimension(38 +/- 7 vs 45 +/- 6 mm, p < 0.05).


CONCLUSIONS
Pilsicainide hydrochloride is effective in patients with atrial fibrillation of short duration with small left atrium and rapid ventricular response.
Matsushita
Kohei
K
Second Department of Internal Medicine, Yokohama City University School of Medicine, Fukuura 3-9, Kanazawa-ku, Yokohama 236-0004.
Ishikawa
Toshiyuki
T
Sumita
Shinichi
S
Kobayashi
Tsukasa
T
Matsumoto
Katsumi
K
Yamakawa
Yohei
Y
Ohkusu
Yasuo
Y
Nakagawa
Takeshi
T
Nakazawa
Ichiroh
I
Mochida
Yasuyuki
Y
Ebina
Toshiaki
T
Uchino
Kazuaki
K
Kimura
Kazuo
K
Umemura
Satoshi
S
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004562:Electrocardiography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008012:Lidocaine / Q000008:administration & dosage / Q000031:analogs & derivatives* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged
D000889:Anti-Arrhythmia Agents; D008012:Lidocaine; C042288:pilsicainide