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Oral Loading with Propafenone: A Placebo‐Controlled Study in Elderly and Nonelderly Patients with Recent Onset Atrial Fibrillation
Author(s) -
BORIANI GIUSEPPE,
BIFFI MAURO,
CAPUCCI ALESSANDRO,
BOTTO GIAN LUCA,
BROFFONI TIZIANA,
RUBINO IDA,
CASA STEFANO,
SANGUINETTI MARIO,
BRANZI ANGELO,
MAGNANI BRUNO
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb01202.x
Subject(s) - medicine , propafenone , sinus rhythm , atrial fibrillation , placebo , adverse effect , cardiology , anesthesia , gastroenterology , alternative medicine , pathology
The efficacy and safety of propafenone as an oral loading dose (600‐mg single oral dose) in converting recent‐onset atrial fibrillation (≤ 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 ≤ 2 without signs or symptoms of heart failure were enrolled: among patients aged ≤ 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 plocebo at 3 and 8 hours. For patients aged ≤ 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 = 2.12–10.54, 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 ≤ 60 years (P = 0.0064) and by propafenone treatment (P < 0.0001), and conversion to sinus rhythm within 8 hours was predicted by age ≤ 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 sinus rhythm appears to occur less frequently in elderly patients.