Propafenon und Lidoflazin bei chronischem Vorhofflimmern und -flattern

Abstract

60 patients with chronic atrial fibrillation and flutter were randomly allotted to two groups and treated alternately with two different therapy regimes. 30 patients (group I) received lidoflazine in increasing dosage up to 480 mg/24 h and in cases where there was no conversion to sinus rhythm propafenon in a maximal daily dosage of 1800 mg orally. The duration of treatment was limited to 4 days for each substance. 30 patients (group II) were treated in the reverse order, i.e. propafenon and in cases of ineffectiveness with lidoflazine. Atrial fibrillation could be overcome in 21 patients in group I and in 23 patients in group II. The combined success rate in both groups was 73%. The conversion rates for the individual substances were 41% for propafenon (17 out of 41 patients) and 59% for lidoflazine (27 out of 46 patients). The difference was not statistically significant. Successive use of both substances leads to an increased conversion rate. Dangers arising from therapy are a conduction inhibitory action and depression of sinus node function as far as propafenol is concerned and the risk of ventricular ectopy and tachyarrhythmia in lidoflazine.

Review : Electrophysiologic and Antiarrhythmic Effects of Propafenone: Focus on Atrial Fibrillation

“…Early after the drug's release, Beck et al (126) reported a 41 % conversion rate in chronic AF. Later on, Vita et al (127) reported a disappointing success rate for cardioversion of 9% for propafenone and 4% for placebo using intravenous propafenone.…”

“…Use in Paroxysmal Supraventricular Tachycardia Since the availability of radiofrequency ablation techniques, the role of pharmacological therapies for the long-term management of PSVT has narrowed. Nevertheless, propafenone has been used successfully for PSVT in a number of trials (116,120,126,(131)(132)(133)(134), although some have been limited to electrophysiologic studies (37, [135][136][137][138][139][140][141][142].…”