The efficacy and safety of intravenous propafenone versus intravenous amiodarone in the conversion of atrial fibrillation or flutter after cardiac surgery

Larbuisson, Robert; Venneman, Ingrid; Stiels, Brigitte

doi:10.1016/s1053-0770(96)80243-6

Cited by 43 publications

(33 citation statements)

References 12 publications

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“…70 Two studies of intravenous amiodarone and propafenone in postoperative AF of 40 and 84 patients, respectively, observed little difference between drugs, although there was a small trend in each study in favor of amiodarone at 24 hours with conversion rates of 67% versus 77% (PϭNS) 75 and 68% versus 83% (PϭNS). 76 Interestingly, in both studies, early (1 hour) conversion rates were significantly better with propafenone, suggesting a more delayed onset of action with amiodarone. Other small, randomized studies of acute AF conversion have found intravenous amiodarone to be similar to intravenous procainamide, 77 and in 1 trial, significantly less effective than magnesium sulfate.…”

Section: Amiodarone For Afmentioning

confidence: 85%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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Section: Amiodarone For Afmentioning

confidence: 85%

Evidence-Based Analysis of Amiodarone Efficacy and Safety

1999

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“…Two randomized trials assessed the efficacy of amiodarone compared with propafenone in reversing AF after cardiac surgery. 9,10 In the first study, 84 patients with sustained AF were randomized to receive IV amiodarone or IV propafenone. Within 24 h, 38 of 46 patients (82.6%) given amiodarone and 26 of 38 patients (68.4%) given propafenone converted to sinus rhythm, the difference was not significant.…”

Section: Introductionmentioning

confidence: 99%

“…Mean blood pressure was not significantly influenced by either drug. In the second study, 10 forty patients undergoing cardiac surgery either received propafenone IV or amiodarone IV for treatment of postsurgical AF. Sinus rhythm was restored in 12 of 18 (67%) propafenone patients and in 17 of 22 (77%) amiodarone patients, the difference was not statistically significant.…”

Section: Introductionmentioning

confidence: 99%

Amiodarone for Atrial Fibrillation Following Cardiac Surgery: Development of Clinical Practice Guidelines at a University Hospital

Khanderia¹,

Wagner²,

Walker³

et al. 2007

Clinical Cardiology

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SummaryAtrial fibrillation (AF) usually develops within the first 72 h following cardiac surgery, and is often selflimiting. Within 48 h of acute onset of symptoms, approximately 50% of patients spontaneously convert to normal sinus rhythm. Thus, the relative risks and benefits of therapy must be carefully considered. The etiology of AF following cardiac surgery is similar to that in nonsurgical patients except that pericardial inflammation and increased adrenergic tone play an increasingly important role. Further, AF after surgery may be associated with transient risk factors that resolve as the patient moves out from surgery, and the condition is less likely to recur compared with AF arising in other circumstances. Immediate heart rate control is important in preventing ischemia, tachycardia-induced cardiomyopathy, and left ventricular dilatation.At our institution, amiodarone is frequently used as a first-line drug for treating AF after cardiac surgery. Inconsistent prescribing practices, variable dosage regimens, and a lack of consensus regarding the appropriate use of amiodarone prompted the need for developing practice guidelines. Multidisciplinary collaboration between the departments of cardiac surgery, pharmacy, and anesthesiology led to the development of a protocol for postoperative AF. We review the clinical evidence from published trials and discuss our guidelines, defining amiodarone use for AF in the cardiac surgery setting.

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“…Furthermore, Ventura et al [22] reported that patients who were previously medicated with amiodarone had a higher recurrence rate of arrhythmia compared with those who had not been previously medicated with antiarrhythmic drugs or those who had been medicated with anti-arrhythmic that had short plasma half-lives, in particular propafenone. Additionally, in their series, Sestito and Molina [23] found no differences regarding the side effects of propafenone and a placebo, and Larbuisson et al [24] suggested that propafenone produces a more prompt effect in converting patients from AF to normal sinus rhythm than amiodarone.…”

Section: Discussionmentioning

confidence: 98%