Document Detail


Regular ventricular rhythms before conversion of recent onset atrial fibrillation to sinus rhythm.
MedLine Citation:
PMID:  7845827     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The incidence of fast atrial tachycardias with regular ventricular rhythm was assessed in a population of 243 patients with recent onset (< 72 hours) atrial fibrillation (AF), without heart failure, randomly treated with single loading oral dose of propafenone (600 mg), flecainide (300 mg), digoxin (1 mg), or placebo for acute conversion to sinus rhythm (SR). Fast atrial arrhythmias developed in 14 (6%) patients: 6/92 treated with propafenone, 3/34 treated with flecainide, 1/25 treated with digoxin, and 4/92 who received placebo (P = NS). Heart rate > 175 beats/min with 1:1 AV conduction ensued in 4 cases: 2 treated with flecainide and 2 treated with placebo; in the other cases 2:1 AV conduction was observed. Widening of QRS during regular tachycardia was observed in 4 patients; 3 who received propafenone and 1 who received flecainide. Conversion to SR within 4 hours was achieved in 55/92 (60%) patients treated with propafenone, 20/34 (59%) patients treated with flecainide, 7/25 (28%) patients treated with digoxin, and 19/92 (20%) treated with placebo (P < 0.001 propafenone vs placebo and flecainide vs placebo; P < 0.05 propafenone vs digoxin and flecainide vs digoxin). Periods of regular tachycardia are expected in recent onset AF and may not necessarily represent a proarrhythmic effect of Class 1C drugs, rather than mark the transition from AF to SR. Class 1C agents are probably responsible for widening of the QRS complex seen during these tachycardias. Propafenone and flecainide appear equally effective in converting recent onset AF.
Authors:
G L Botto; W Bonini; T Broffoni; G Cappelletti; C Falcone; R Lombardi; A Paulesu; E Pedraglio; G Ferrari
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  17     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1994 Nov 
Date Detail:
Created Date:  1995-03-06     Completed Date:  1995-03-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  2114-7     Citation Subset:  IM    
Affiliation:
Department of Cardiology, St. Anna Hospital, Como, Italy.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / diagnosis,  drug therapy,  physiopathology*
Digoxin / therapeutic use
Electrocardiography
Electrocardiography, Ambulatory
Female
Flecainide / therapeutic use
Heart Rate*
Humans
Male
Middle Aged
Propafenone / therapeutic use
Ventricular Function*
Chemical
Reg. No./Substance:
20830-75-5/Digoxin; 54063-53-5/Propafenone; 54143-55-4/Flecainide

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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