This Article Figures Only Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Kochiadakis, G. E. Articles by Vardas, P. E. Search for Related Content PubMed PubMed Citation Articles by Kochiadakis, G. E. Articles by Vardas, P. E.

CLINICAL STUDIES

Amiodarone versus propafenone for conversion of chronic atrial fibrillation: results of a randomized, controlled study

^a Cardiology Department, University Hospital of Heraklion, Heraklion, Crete, Greece

Manuscript received July 23, 1998; revised manuscript received October 20, 1998, accepted December 11, 1998.

Reprint requests and correspondence: Dr. P. E. Vardas, Cardiology Department, Heraklion University Hospital, P.O. Box 1352 Stavrakia, Heraklion, Crete, Greece
cardio{at}danae.med.uoc.gr

OBJECTIVES

The purpose of this study was to investigate the efficacy and safety of amiodarone and propafenone in the conversion of chronic atrial fibrillation in a prospective, randomized, placebo-controlled study.

BACKGROUND

The effectiveness of amiodarone and propafenone in the treatment of patients with chronic atrial fibrillation has not been adequately studied.

METHODS

One hundred one patients (48 men, mean age 64 ± 9 years) with atrial fibrillation lasting >3 weeks participated in the study. Thirty-four patients received amiodarone (300 mg intravenously over 1 h, followed by 20 mg/kg over the next 24 h plus 600 mg orally, in three doses, for 1 week, then 400 mg/day orally, for three weeks), 32 received propafenone (2 mg/kg intravenously over 15 min, followed by 10 mg/kg over 24 h and then 450 mg/day orally, for one month) and the remaining 35 served as control subjects. All patients received digoxin and anticoagulant treatment as indicated (International Normalized Ratio 2 to 3).

RESULTS

Conversion to sinus rhythm was achieved in 16 (47.05%) patients who received amiodarone, in 13 (40.62%) who received propafenone and in none of the control subjects (p < 0.001 for both groups vs. control subjects). Those who converted had smaller atria than those who did not and atrial fibrillation of shorter duration in both the amiodarone and propafenone groups. Treatment was discontinued in one patient of the propafenone group because of significant QRS widening.

CONCLUSIONS

Amiodarone and propafenone appear to be safe and equally effective in the termination of chronic atrial fibrillation. Left atrial diameter and arrhythmia duration are independent predictors of conversion.

Abbreviations and Acronyms   ECG = electrocardiogram   NS = non-significant   SD = standard deviation

This article has been cited by other articles:

				C. Varounis, N. Dagres, T. Maounis, D. Panagiotakos, and D. V. Cokkinos Atrial premature complexes and heart rate have prognostic significance in 1-month atrial fibrillation recurrence after electrical cardioversion Europace, August 1, 2007; 9(8): 633 - 637. [Abstract] [Full Text] [PDF]

				Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]

				V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]

				V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]

				P Korantzopoulos, T M Kolettis, A Papathanasiou, K K Naka, P Kolios, I Leontaridis, A Draganigos, C S Katsouras, and J A Goudevenos Propafenone added to ibutilide increases conversion rates of persistent atrial fibrillation Heart, May 1, 2006; 92(5): 631 - 634. [Abstract] [Full Text] [PDF]

				Z. Qu Critical mass hypothesis revisited: role of dynamical wave stability in spontaneous termination of cardiac fibrillation Am J Physiol Heart Circ Physiol, January 1, 2006; 290(1): H255 - H263. [Abstract] [Full Text] [PDF]

				Z. Qu and J. N. Weiss Effects of Na+ and K+ channel blockade on vulnerability to and termination of fibrillation in simulated normal cardiac tissue Am J Physiol Heart Circ Physiol, October 1, 2005; 289(4): H1692 - H1701. [Abstract] [Full Text] [PDF]

				P. Zimetbaum and M. E. Josephson Is There a Role for Maintaining Sinus Rhythm in Patients with Atrial Fibrillation? Ann Intern Med, November 2, 2004; 141(9): 720 - 726. [Abstract] [Full Text] [PDF]

				R. L. McNamara, L. J. Tamariz, J. B. Segal, and E. B. Bass Management of Atrial Fibrillation: Review of the Evidence for the Role of Pharmacologic Therapy, Electrical Cardioversion, and Echocardiography Ann Intern Med, December 16, 2003; 139(12): 1018 - 1033. [Abstract] [Full Text] [PDF]

				A Wakai and J O O'Neill Emergency management of atrial fibrillation Postgrad. Med. J., June 1, 2003; 79(932): 313 - 319. [Abstract] [Full Text] [PDF]

				G Nichol, F McAlister, B Pham, A Laupacis, B Shea, M Green, A Tang, and G Wells Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation Heart, June 1, 2002; 87(6): 535 - 543. [Abstract] [Full Text] [PDF]

				B. Darpo Spectrum of drugs prolonging QT interval and the incidence of torsades de pointes Eur. Heart J. Suppl., September 1, 2001; 3(suppl_K): K70 - K80. [Abstract] [PDF]

				M. A. Alpert Medical Cardioversion of Atrial Fibrillation Chest, June 1, 2000; 117(6): 1529 - 1531. [Full Text] [PDF]

				P. E. Vardas, G. E. Kochiadakis, N. E. Igoumenidis, A. M. Tsatsakis, E. N. Simantirakis, and G. I. Chlouverakis Amiodarone as a First-Choice Drug for Restoring Sinus Rhythm in Patients With Atrial Fibrillation : A Randomized, Controlled Study Chest, June 1, 2000; 117(6): 1538 - 1545. [Abstract] [Full Text] [PDF]