Pharmacological Conversion of Recent Onset Atrial Fibrillation: A Randomized Study of Propafenone and Amiodarone
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- Category: Vol. 85, December 2017
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Pharmacological Conversion of Recent Onset Atrial Fibrillation: A Randomized Study of Propafenone and Amiodarone, RAMY M. OMAR, HESHAM S. TAHA, AHMAD M. KAMAL EL-DIN, AHMAD A. SHAMS EL-DIN and MARWA S. MASHAAL
Abstract
Introduction: Atrial Fibrillation (AF) is the most common sustained arrhythmia affecting humans. Several antianhythnxic agents are effective for restoring and maintaining sinus rhythm. and selection of a particular drug depends on many factors, including the presence and type of underlying heart disease, concomitant illnesses, and renal or hepatic dysfunction. Ideally. the pharmacological treatment should have a high conversion rate or be able to control the improper high ventricular rate, being rapid in action and have a low incidence of side effects.
Aim of the Work: To compare the efficacy and rapidity of recent onset AF conversion by oral propafenone versus intravenous infusion of amiodarone.
Patients and Methods: We investigated 50 patients with-recent onset AF who were admitted to Kest El-Aini Hospitals. The patients were randomly divided into two groups the first group (Group A) consisted of 25 patients in which amiodaronc was administrated, and the other group (Group B) consisted of 25 patients in which propafenone was administrated.
Results: Patients in Group A were successfully converted into sinus rhythm compared to of patients in Group B (88% versus 84%). The time elapsed from drug administration till conversion of AF into sinus rhythm in Group A was 9:071 5:04 hours, while that of Group В was 3:91l:54 hours (pvalue=l.001. There was a negative and significant correlation between number of previous episodes of AF, diabetes mellitus, hypertension, basal ventricular rate and left atrial diameterand success rate of conversion of AF in both groups.
Conclusion: Time needed for conversion of AF into sinus rhythm using oral propafenone is significantly shorter than time needed by atniodarone. Number of previous episodes of AF, DM, hypertension, basal ventricular rate and left atrial diameterare inversely proportionate to the success rate of AF conversion.