• M Balik, I Kolnikova, M Maly, P Waldauf, G Tavazzi, and J Kristof.
• Department of Anesthesiology and Intensive Care, 1st Faculty of Medicine, Charles University, General University Hospital in Prague, Czechia. Electronic address: martin.balik@vfn.cz.
• J Crit Care. 2017 Oct 1; 41: 162316-23.

PurposeThe occurence of supraventricular arrhythmias associate with an unfavourable prognosis in septic shock. Propafenone could be a feasible antiarrhythmic.Materials And MethodsPatients collected over a period of 24months were divided into the three groups based on antiarrhythmic: Group1(amiodarone), Group2(propafenone), Group3(metoprolol). Type of arrhythmia, cardioversion rates, demographic, haemodynamic, laboratory parameters were recorded in the first 24h. The outcome data were compared between the groups.Results234 patients (99.1% ventilated) were included, the prevailing arrhythmia was acute onset atrial fibrillation (AF,69.7%). Except for the dosage of noradrenaline (0.35(0.14-0.78) in Group1(n=142)vs 0.25(0.10-0.50),p<0.01 in Group2(n=78)vs 0.14(0.07-0.25)μg/kg·min,p<0.05 in Group3(n=14)) the ejection fraction of left ventricle, rates of renal replacement therapy, arterial lactate and procalcitonin levels were not different between the groups. The cardioversion rate in Group1(74%) was lower than in Group2(89%) and Group3(92%). ICU and 28-day mortalities of Group1 were not significantly higher than in Group2 and Group3. Multivariate analysis demonstrated higher 12-month mortality in Group1 than in Group2 (HR1.58(1.04;2.38),p=0.03).ConclusionsPropafenone demonstrated a higher cardioversion rate than amiodarone with a similar impact on the outcome. Patients remaining in acute onset arrhythmia did not demonstrate significantly higher ICU, 28-day and 12-month mortalities compared to those successfully cardioverted or to those having chronic AF.Copyright © 2017 Elsevier Inc. All rights reserved.

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