Effects of oral propafenone administration before electrical cardioversion of chronic atrial fibrillation: A placebo-controlled study

Abstract

Propafenone, given before electrical cardioversion for chronic atrial fibrillation does not affect the mean defibrillation threshold or the rate of successful arrhythmia conversion. It decreases the recurrence of atrial fibrillation early after shock, thus allowing more patients to be discharged from the hospital with sinus rhythm.

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Wcześniejsze podanie amiodaronu (wymagające kilku tygodni leczenia) [631,632], sotalolu [631], ibutilidu [633] lub wernakalantu [634] może zwiększyć skuteczność kardiowersji elektrycznej, a podobny efekt występuje prawdopodobnie w przypadku podania flekainidu [584] lub propafenonu [635]. Nie ma wiarygodnych danych, które wskazywałyby, że beta-adrenolityki [636], werapamil, diltiazem [637][638][639] oraz digoksyna [640,641] są skuteczne jako leki przerywające AF lub ułatwiające kardiowersję elektryczną.…”

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…Compared with placebo, propafenone did not influence either the mean defibrillation threshold or the rate of conversion (shock efficacy 84% vs. 82%, respectively) but suppressed immediate recurrences (within 10 min), and 74% versus 53% of patients were in sinus rhythm after 2 d. 522 In patients with persistent AF, pretreatment with intravenous flecainide had no significant effect on the success of direct-current cardioversion. 717 …”

Initial Energy for External Electrical Cardioversion of Atrial Fibrillation

“…Randomized studies show that previous use of antiarrhythmic drugs enhances the efficacy of electrical cardioversion or, at least, decreases early recurrence of atrial fibrillation [12][13][14][15] .…”