The Canadian journal of cardiology
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Clinical Trial Controlled Clinical Trial
The inefficacy of intravenous propafenone for rate control in atrial fibrillation.
The antiarrhythmic agent propafenone has been reported to prolong atrioventricular node conduction and may be suitable for rate control in atrial fibrillation (AF). To evaluate this, 10 patients (seven men and three women aged 29 to 67 years, mean +/- SD 48 +/- 14) were given intravenous propafenone during AF in both the supine and upright positions. Intracardiac catheters measured local electrograms from the high right atrium and right ventricular apex during AF. ⋯ In contrast, propafenone markedly increased the mean atrial cycle length (136 +/- 35 versus 226 +/- 39, P < 0.001). The mean ventricular cycle length reverted to baseline after tilt (447 +/- 103 ms) while the mean atrial cycle length decreased but not to baseline levels (170 +/- 21 ms). The authors conclude that intravenous propafenone is generally inadequate for rate control in AF, especially in the upright position.