Efficacy and safety of antazoline in the rapid cardioversion of paroxysmal atrial fibrillation (the AnPAF Study).
OBJECTIVE
The aim of the study was to assess the clinical efficacy of antazoline, a first-generation anti-histaminic agent, in the rapid conversion of paroxysmal non-valvular atrial fibrillation (AF) to sinus rhythm in patients without heart failure.


RESULTS
This study was a single center, randomized, double blind, placebo-controlled, superiority clinical trial. We enrolled patients with an AF episode lasting less than 43 h, in stable cardiopulmonary condition. Subjects who fulfilled the selection criteria were randomly assigned to receive intravenously either a placebo or up to 250 mg of antazoline. The primary end point was the conversion of AF to sinus rhythm confirmed in electrocardiogram (ECG). We enrolled 74 patients: 36 (48.6%) in the antazoline group and 38 (51.4%) in the control group. The mean age was 68 ± 12 years (range 31-90 years), 39 (53.3%) patients were male. The successful conversion of AF to sinus rhythm during the observation period was achieved in 26 (72.2%) patients treated with antazoline and 4 (10.5%) in the control group: RR 6.86 (95% CI: 2.66-17.72, P < 0.0001). Median time to conversion was 16.0 min in antazoline and 72.5 min in the control group (P = 0.0246). There were no cases of atrial tachycardia/flutter in the antazoline group.


CONCLUSIONS
Intravenous antazoline was effective and safe in the rapid conversion of non-valvular paroxysmal atrial fibrillation to sinus rhythm in patients without heart failure. Clinical Trial Registration number: NCT01527279.
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Aleksander
A
Maciag
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Michal M
MM
Farkowski
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Tomasz
T
Chwyczko
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Maciej
M
Beckowski
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Pawel
P
Syska
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Ilona
I
Kowalik
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Mariusz
M
Pytkowski
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Jacek
J
Wozniak
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Rafal
R
Dabrowski
The 2nd Department of Coronary Artery Disease, Institute of Cardiology, Spartanska 1, 02-637 Warsaw, Poland.
Hanna
H
Szwed
D000200:Action Potentials / Q000187:drug effects; D061605:Administration, Intravenous; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000865:Antazoline / Q000008:administration & dosage* / Q000009:adverse effects; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage* / Q000009:adverse effects; D001281:Atrial Fibrillation / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D004311:Double-Blind Method; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000187:drug effects* / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects*; D006634:Histamine H1 Antagonists / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011044:Poland; D013997:Time Factors; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D006634:Histamine H1 Antagonists; D000865:Antazoline
Antazoline  • Atrial fibrillation • Pharmacological
                    cardioversion • Randomized controlled trial