title: Propafenone for the prevention of atrial tachyarrhythmias after cardiac surgery: a randomized, double-blind placebo-controlled trial.
abstract: We studied the efficacy of propafenone in preventing atrial tachyarrhythmias after cardiac surgery, and the possible relationships between CYP2D6 polymorphism and the efficacy, pharmacokinetics, and tolerability of propafenone. One hundred and sixty patients were randomized (double blind) to receive propafenone (n= 78) or placebo (n= 82) for 1 week after cardiac surgery. The patients who were assigned to the propafenone group received 1 mg/kg infused in 1 h, followed by a continuous infusion at a rate of 4 mg/kg/24 h until the following morning, and subsequently 450 mg/day orally until the sixth postoperative day. Thirty-seven patients completed the trial in the propafenone group and 45 in the placebo group. The frequency of occurrence of atrial tachyarrhythmia was lower in the propafenone group than in the placebo group (29.7% vs. 53.3%, P< 0.05; relative risk, 0.56). Plasma propafenone concentrations were markedly influenced by CYP2D6 genotype-derived phenotype.
authors.affiliation: Department of Clinical Pharmacology, Institute of Pharmacology and Toxicology, Tübingen University Hospital, Tübingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Mörike
authors.forename: K T
authors.initials: KT
authors.lastname: Kivistö
authors.forename: E
authors.initials: E
authors.lastname: Schaeffeler
authors.forename: C
authors.initials: C
authors.lastname: Jägle
authors.forename: S
authors.initials: S
authors.lastname: Igel
authors.forename: S
authors.initials: S
authors.lastname: Drescher
authors.forename: R
authors.initials: R
authors.lastname: Fux
authors.forename: C
authors.initials: C
authors.lastname: Marx
authors.forename: U
authors.initials: U
authors.lastname: Hofmann
authors.forename: C
authors.initials: C
authors.lastname: Engel
authors.forename: F
authors.initials: F
authors.lastname: Wagner
authors.forename: U
authors.initials: U
authors.lastname: Delabar
authors.forename: C
authors.initials: C
authors.lastname: Meisner
authors.forename: D
authors.initials: D
authors.lastname: Bail
authors.forename: J O
authors.initials: JO
authors.lastname: Böhm
authors.forename: C H
authors.initials: CH
authors.lastname: Gleiter
authors.forename: G
authors.initials: G
authors.lastname: Ziemer
authors.forename: J G
authors.initials: JG
authors.lastname: Rein
authors.forename: K D
authors.initials: KD
authors.lastname: Hellberg
authors.forename: M
authors.initials: M
authors.lastname: Eichelbaum
authors.forename: M
authors.initials: M
authors.lastname: Schwab
mesh_terms: D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000097:blood / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000201:enzymology / Q000235:genetics / Q000517:prevention & control*; D019389:Cytochrome P-450 CYP2D6 / Q000235:genetics / Q000378:metabolism; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011110:Polymorphism, Genetic / Q000235:genetics; D011183:Postoperative Complications / Q000201:enzymology / Q000517:prevention & control; D011405:Propafenone / Q000097:blood / Q000627:therapeutic use*; D013610:Tachycardia / Q000201:enzymology / Q000235:genetics / Q000517:prevention & control*; D013903:Thoracic Surgery
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D019389:Cytochrome P-450 CYP2D6