Oral loading with propafenone: A placebo-controlled study in elderly and nonelderly patients with recent onset atrial fibrillation

被引:17
作者
Boriani, G
Biffi, M
Capucci, A
Botto, GL
Broffoni, T
Rubino, I
Della Casa, S
Sanguinetti, M
Branzi, A
Magnani, B
机构
[1] Univ Bologna, Inst Cardiol, I-40138 Bologna, Italy
[2] Osped Civile, Dept Cardiol, Lugo, Spain
[3] Osped S Anna, Dept Cardiol, Como, Italy
来源
PACE-PACING AND CLINICAL ELECTROPHYSIOLOGY | 1998年 / 21卷 / 11期
关键词
antiarrhythmic drugs; atrial fibrillation; conversion; Holter monitoring;
D O I
10.1111/j.1540-8159.1998.tb01202.x
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
The efficacy and safety of propafenone as an oral loading dose (600-mg single oral dose) in converting recent-onset atrial fibrillation (less than or equal to 7 days duration) to sinus rhythm were evaluated in a single-blind, placebo-controlled study according to patients' age. Overall, 240 hospitalized patients, NYHA Class less than or equal to 2 without signs or symptoms of heart failure were enrolled: among patients aged less than or equal to 60 years, 55 were allocated to propafenone treatment and 59 to placebo, respectively, and among patients aged > 60 years, 64 were allocated to propafenone treatment and 62 to placebo, respectively. Results: In each age group, the likelihood of conversion to sinus rhythm was significantly greater after propafenone compared with placebo at 3 and 8 hours. For patients aged less than or equal to 60 years, corresponding odd ratios were 3.78 (95% CI = 1.80-7.92, P = 0.04) at 3 hours and 4.74 (95% CI = 2.22-10.54, P = 0.02) at 8 hours; for patients aged > 60 years odd ratios were 5.03 (95% CI = 2.08-12.12, P = 0.02) at 3 hours and 6.75 (95% CI = 3.28-73.86, P = 0.01) at 8 hours, respectively. Logistic regression analysis showed that conversion to sinus rhythm within 3 hours was predicted by age less than or equal to 60 years IP = 0.0064) and by propafenone treatment IP ( 0.0001), and conversion to sinus rhythm within 8 hours was predicted by age less than or equal to 60 years(P = 0.0467) and by propafenone treatment (P ( 0.0001). The occurrence of adverse effects was observed in 14%-16% of propafenone treated patients and in 8% of placebo treated patients without significant differences according to age. In conclusion, in patients with recent-onset atrial fibrillation without signs of heart failure, propafenone as a single oral loading dose is effective. It is also effective in selected elderly subjects with a favorable safety profile. Moreover, spontaneous conversion to sin us rhythm appears to occur less frequently in elderly patients.
引用
收藏
页码:2465 / 2469
页数:5
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