Predictors of success in the conversion of new-onset atrial fibrillation using oral propafenone

Ergene, Ülkü; Ergene, Oktay; Çete, Yıldıray; Fowler, Jacqueline; Nazli, Cem; Oktay, Cem

doi:10.1097/00063110-199812000-00008

Cited by 18 publications

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“…Studies have found increasing symptom duration to be a negative predictor of successful cardioversion. 14,15 This was not confirmed in our study, perhaps because patients presented relatively early, before any difference would have been found.…”

Section: Comparison To Prior Studiescontrasting

confidence: 67%

Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

Blecher

Stiell

Rowe

et al. 2012

CJEM

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Objective: It is believed that when patients present to the emergency department (ED) with recent-onset atrial fibrillation or flutter (RAFF), controlling the ventricular rate before cardioversion improves the success rate. We evaluated the influence of rate control medication and other variables on the success of cardioversion.Methods: This secondary analysis of a medical records review comprised 1,068 patients with RAFF who presented to eight Canadian EDs over 12 months. Univariate analysis was performed to find associations between predictors of conversion to sinus rhythm including use of rate control, rhythm control, and other variables. RÉ SUMÉObjectif: On croit que lorsqu'un patient se pré sente au service des urgences (SU) en é tat de fibrillation auriculaire (flutter) ré cente, le contrôle de la fré quence ventriculaire avant l'amé lioration de la cardioversion augmente le taux de ré ussite. Nous avons é valué l'influence des mé dicaments de contrô le de la fré quence et d'autres variables sur l'amé lioration de la cardioversion. Mé thodes: Cette deuxiè me analyse des dossiers mé dicaux porte sur 1 068 patients en é tat de fibrillation auriculaire (flutter) ré cente qui se sont pré senté s dans huit services des urgences au Canada au cours des 12 derniers mois. Une analyse univarié e a é té effectué e afin d'é tablir des liens entre les pré dicteurs de conversion et le rythme sinusal, y compris le contrô le de la fré quence, le contrô le du rythme, et d'autres variables. Les variables pré dictives ont é té inté gré es au modè le à plusieurs variables afin de calculer les ratios d'incidence approché s (RIA) redressé s associé s à la ré ussite de la cardioversion. (IC 95 % 0,83). Les RIA pour les facteurs lié s aux cardioversions pharmacologiques ré ussies é taient l'utilisation de mé dicaments de contrô le de la fré quence, 1,29 (IC 95 % 0,82-2,03); le sexe fé minin, 2,37 (IC 95 % 1,50-3,72); et l'utilisation de la procaïnamide, 2,32 (CI 95 % 1,43-3,74).Conclusion: Nous avons dé montré un taux de ré ussite plus faible des cardioversions pour les patients en é tat de fibrillation auriculaire (flutter) ré cente lorsque ces derniers avaient pré alablement pris des mé dicaments de contrô le de la fré quence ou du rythme. Les mé dicaments de contrô le de la fré quence n'é taient pas associé s à un taux de ré ussite plus é levé des cardioversions pharmacologiques, contrairement à la procaïnamide. Il faudrait é viter de ralentir la fré quence ventriculaire avant la cardioversion.Keywords: atrial fibrillation, cardioversion, rate control Atrial fibrillation (AF) affects an estimated 2.2 million Americans and is present in 8 to 10% of those over 80 years old.1 The major morbidity associated with AF or atrial flutter (AFL) is from thromboembolism, particularly to the cerebral circulation. In managing this risk, one of two competing management strategies is recommended: rate control or rhythm control.Symptomatic AF or AFL with rapid ventricular response is a common presentation to emergency departments (ED...

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Section: Comparison To Prior Studiescontrasting

confidence: 67%

Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

Blecher

Stiell

Rowe

et al. 2012

CJEM

View full text Add to dashboard Cite

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“…Hypertension, left atrial dilatation, left ventricular hypertrophy, obesity, age, and structural heart disease increase the lifetime risk of AF 17–21 . Furthermore, previous studies demonstrated that duration of AF, concomitant medication, and left atrial dimensions influence maintenance of sinus rhythm after medical and electrical cardioversion 22–24 . Only limited data exist on patients' characteristics and the clinical outcome in patients after ablation or its influence on complexity of ablation 25–28 …”

Section: Discussionmentioning

confidence: 99%

“…[17][18][19][20][21] Furthermore, previous studies demonstrated that duration of AF, concomitant medication, and left atrial dimensions influence maintenance of sinus rhythm after medical and electrical cardioversion. [22][23][24] Only limited data exist on patients' characteristics and the clinical outcome in patients after ablation or its influence on complexity of ablation. [25][26][27][28] The present study demonstrates that several clinical variables are associated with noninducibility of sustained AF after PVI.…”

Section: Clinical Predictors Of Noninducibility Of Sustained Afmentioning

confidence: 99%

Clinical Predictors of Noninducibility of Sustained Atrial Fibrillation After Pulmonary Vein Isolation

Rotter

Jaı̈s

Garrigue

et al. 2005

Cardiovasc electrophysiol

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“…12 Experimental studies have found that bisoprolol extends ERP of the atria and has a potential antiarrhythmic effect in the treatment of AF. [13][14][15] It is possible to co-administer bisoprolol with propafenone 16 , which due to its high effi ciency, is a drug of fi rst choice for treatment of atrial fi brillation [17][18][19][20] . Based in these fi ndings we can use bisoprolol as the drug for a selective beta-blockade in propafenone treatment.…”

Section: Discussionmentioning

confidence: 99%

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

Negreva

Penev²

2012

Folia Medica

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The incidence of atrial fi brillation has been rapidly increasing in recent years. The increased tonus of the sympathetic nervous system is related to the development of atrial fi brillation. OBJECTIVE: To study the effect of bisoprolol, a highly selective beta-blocker, on patients with recent-onset atrial fi brillation (< 48 hours) for regularization of the rhythm using propafenone. PATIENTS AND METHODS: The study includes 164 patients (81 women, 83 men, age 59.09 ± 10.81) with successfully restored sinus rhythm in recent-onset atrial fi brillation. The patients received either propafenone (group A, n = 82) or a combination of propafenone and bisoprolol (group B, n = 82). The studied patients were randomly allocated to the groups. Propafenone was administered intravenously as a 2 mg/kg bolus followed by infusion of 0.0078 mg/kg/min for 120 min and orally in dosage of 300 mg three times every 8 hours if arrhythmia persisted. Bisoprolol was administered in a single dose at the very beginning of propafenone treatment and only in patients from group B at a dose of 5 or 10 mg. Regularization of the rhythm was assessed at the 3rd, 6th, 12th and 24th hour. RESULTS: In the initial stages of regularization the combined therapy restored the sinus rhythm in a greater number of patients in comparison with the monotherapy (at the 6th hour 67.07% in group B versus 48.78% in group A, P < 0.05; at the 12th hour it was 87.80% versus 75.60%, respectively, P < 0.05). CONCLUSION: Early regularization of rhythm in patients with recent-onset atrial fi brillation reduces the likelihood of recurrent episodes of arrhythmia. This makes the application of selective beta-blockade clinically signifi cant.

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Predictors of success in the conversion of new-onset atrial fibrillation using oral propafenone

Cited by 18 publications

References 0 publications

Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

Clinical Predictors of Noninducibility of Sustained Atrial Fibrillation After Pulmonary Vein Isolation

Effect of selective beta-blockade with bisoprolol in the treatment of recent-onset atrial fibrillation

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