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PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
6
pubmed:dateCreated
2001-9-20
pubmed:abstractText
This study was performed to evaluate, using a randomized double-blind, placebo-controlled protocol, the long-term efficacy and safety of propafenone and sotalol in maintaining sinus rhythm after conversion of recurrent symptomatic atrial fibrillation (AF). The maintenance of sinus rhythm in patients with recurrent AF has several potential benefits, the most important being a reduced risk of thromboembolic events. Three hundred patients with recurrent AF (> or = 4 episodes in the last year) and AF at enrollment lasting < 48 hours were randomized to receive either propafenone (mean daily dose 13 +/- 1.5 mg/kg; 102 patients), sotalol (mean daily dose 3 +/- 0.4 mg/kg; 106 patients), or placebo (92 patients). After 1-year follow-up, Kaplan-Meier estimates of the proportion of patients remaining in sinus rhythm were comparable between propafenone (63%) and sotalol (73%) and superior to placebo (35%; p = 0.001 vs both drugs). Symptomatic recurrences occurred later with propafenone and sotalol than with placebo. Nine patients (9%) in the propafenone group, 11 (10%) in the sotalol group, and 3 (3%) in the placebo group discontinued therapy due to adverse effects. Malignant nonfatal arrhythmias due to proarrhythmic effects were documented with sotalol only, and occurred < 72 hours from the beginning of therapy in 4 patients (4%). During recurrences, the ventricular rate was significantly reduced in patients taking propafenone and sotalol (p = 0.001 for both drugs vs placebo). The likelihood of remaining in sinus rhythm during follow-up was higher in younger patients with smaller left atrial size and without concomitant heart disease. In patients with recurrent symptomatic AF, propafenone and sotalol are not significantly different from each other and are superior to placebo in maintaining sinus rhythm at 1 year. Recurrences occur later and tend to be less symptomatic with propafenone and sotalol compared with placebo.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Sep
pubmed:issn
0002-9149
pubmed:author
pubmed:issnType
Print
pubmed:day
15
pubmed:volume
88
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
640-5
pubmed:dateRevised
2004-11-17
pubmed:meshHeading
pubmed-meshheading:11564387-Administration, Oral, pubmed-meshheading:11564387-Adult, pubmed-meshheading:11564387-Aged, pubmed-meshheading:11564387-Anti-Arrhythmia Agents, pubmed-meshheading:11564387-Atrial Fibrillation, pubmed-meshheading:11564387-Disease-Free Survival, pubmed-meshheading:11564387-Double-Blind Method, pubmed-meshheading:11564387-Drug Administration Schedule, pubmed-meshheading:11564387-Electrocardiography, Ambulatory, pubmed-meshheading:11564387-Female, pubmed-meshheading:11564387-Humans, pubmed-meshheading:11564387-Italy, pubmed-meshheading:11564387-Longitudinal Studies, pubmed-meshheading:11564387-Male, pubmed-meshheading:11564387-Middle Aged, pubmed-meshheading:11564387-Propafenone, pubmed-meshheading:11564387-Recurrence, pubmed-meshheading:11564387-Sotalol, pubmed-meshheading:11564387-Treatment Outcome
pubmed:year
2001
pubmed:articleTitle
Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation.
pubmed:affiliation
Division of Cardiology, Misericordia e Dolce Hospital, Prato, Italy. cjpfbe@tin.it
pubmed:publicationType
Journal Article, Clinical Trial, Randomized Controlled Trial