ABSTRACT
The aim of this study was to evaluate the efficacy and safety of propafenone in patients with AF after OHS. Twenty patients who underwent OHS [CABG two patients and valve replacement 18 patients] and had AF in the first 48 hours of the study [heart rate >110 b/min., FS >/25%, with fair liver, renal and respiratory functions] received i.v. Propafenone 2 mg/kg. Another group of the patients received placebo as a control. Patients had continuous electrocardiographic, BP and CVP monitoring 0, 15, 30 and 60 minutes from beginning of the infusion. Ten patients reverted to sinus rhythm [all were in sinus rhythm preoperatively] with a mean time of 24 +/- 11 minutes. These patients had significant decrease in CVP. Ten patients did not revert but showed significant decrease in HR [146 +/- 17 b/min. To 104 +/- 17 b/min.] and CVP did not change. No side effects of propafenone were recorded. Control group showed no reversion in sinus rhythm with no change in HR or CVP. It is concluded that i.v. Propafenone is a valuable drug for treatment of AF post OHS. It reverts patients to sinus rhythm and even when ineffective it significantly slowed the heart rate with no detrimental hemodynamic effects