Antazoline for termination of atrial fibrillation during the procedure of pulmonary veins isolation.
OBJECTIVE
Pulmonary vein isolation is a well established method of definite treatment of atrial fibrillation (AF). Periprocedural onset of AF usually terminates spontaneously within minutes, but not in all cases. Antazoline is an antihistaminic agent with antiarrhythmic properties. The aim of our retrospective study was to evaluate the efficacy of antazoline in termination of AF in patients undergoing pulmonary vein isolation.


METHODS
Consecutive 141 patients who received antazoline to terminate AF during pulmonary vein isolation were analyzed. The antazoline was administered at the rate of 30-50mg/min (max. 500mg) after the circumferential ablation in the ostia of pulmonary veins and before confirmation of isolation. Success was defined as restoration of sinus rhythm within 20min after antazoline infusion.


RESULTS
The efficacy of antazoline was 83.6% in paroxysmal and 31.1% in persistent AF patients. Clinical variables that were independently predictive of antazoline ineffectiveness were female (odds ratio [OR]: 4.35; 95% confidence interval [CI]: 1.26-14.3; p=0.018) and AF at the beginning of procedure (OR 28.4; 95% CI 3.89-208.0; p=0.001). Due to antazoline related side effects infusion was discontinued in 7 patients (5%).


CONCLUSIONS
Antazoline seems to be safe agent in termination of AF in patients undergoing pulmonary vein isolation. We also observed satisfying efficacy, which needs to be proved in a randomized clinical trial.
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Paweł
P
Balsam
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Edward
E
Koźluk
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland. Electronic address: michalpeller@gmail.com.
Michał
M
Peller
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Agnieszka
A
Piątkowska
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Piotr
P
Lodziński
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Marek
M
Kiliszek
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Łukasz
Ł
Kołtowski
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Marcin
M
Grabowski
1st Department of Cardiology, Medical University of Warsaw, Warsaw, Poland.
Grzegorz
G
Opolski
D000368:Aged; D000865:Antazoline / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011667:Pulmonary Veins / Q000473:pathology / Q000601:surgery*; D012189:Retrospective Studies; D016896:Treatment Outcome
D000865:Antazoline
Arrhythmia; Atrial fibrillation; Catheter ablation; Pharmacological cardioversion; Pulmonary veins isolation