Propafenone shows class Ic and class II antiarrhythmic effects

Abstract

Both effects on heart rate and blood pressure as well as the changes of plasma concentrations of propafenone during exercise represent two particular features of beta-blockers. Therefore, we conclude that propafenone is both a Class Ic and a Class II antiarrhythmic agent, and 600 mg propafenone, i.e. the dose recommended in current guidelines for cardioversion of paroxysmal atrial fibrillation, cause clinically significant beta-blockade. Thus, single oral doses of 600 mg propafenone appear also suitable for cardioversion of paroxysmal atrial fibrillation in patients with structural heart disease since beta-blockers are explicitly indicated in the treatment of both coronary artery disease and heart failure.

Comparison of the effects ofIK,ACh,IKr, andINablock in conscious dogs with atrial fibrillation and on action potentials in remodeled atrial trabeculae

“…In the present study, dofetilide significantly prolonged the QT interval in conscious animals. Propafenone is a class IC antiarrhythmic drug, exhibiting I Na , betaadrenergic receptor and also HERG-blocking properties (Kohlhardt and Seifert 1980;Stoschitzky et al 2016;Mergenthaler et al 2001), and the drug is successfully applied for rhythm control in AF management due to its conduction-slowing effects (Allessie et al 2001;Kirchhof et al 2016). Propafenone is not recommended in patients with structural heart disease due to ventricular proarrhythmia and increased mortality (CAST Investigators 1989).…”

Comparison of Amiodarone and Propafenone in Blanking Period after Radiofrequency Catheter Ablation in Patients with Atrial Fibrillation: A Propensity Score‐Matched Study

“…The current consensus is that propafenone is suitable for patients without significant ischemic heart disease, significant left ventricular hypertrophy, and heart failure [15]. Although 14.8% of patients were complicated with CAD in the propafenone group, we had excluded patients with acute or old myocardial infarction, unstable angina, and heart failure.…”

An effectiveness of antiarrhythmic therapy for different types of recurrent atrial tachyarrhythmia in early postoperative period after catheter isolation of pulmonary veins

“…Дополнительный β-адрено бло кирующий эффект пропафенона клинически значимым для подавления активации автономной нервной системы в раннем послеоперационном периоде РЧА [2]. Однако ни один исследуемый ААП не доказал свою эффективность для профилактики регулярных ПТ, что подтверждает мнение о трудности контроля ритма посредством ААП данного типа аритмии и частой необходимости повторных вмешательств [15].…”