Efficacy and speed of conversion of recent onset atrial fibrillation using oral propafenone versus parenteral amiodarone: A randomized controlled comparative study

Background: Atrial fibrillation is the most commonly encountered arrhythmia. Several antiarrhythmic agents are effective in restoring and maintaining sinus rhythm. Aim of the work: To compare the efficacy and rapidity of conversion of recent onset atrial fibrillation using oral propafenone versus intravenous infusion of amiodarone. Methods: The study included 200 patients with recent onset atrial fibrillation. Patients were equally divided into 2 groups; group A where intravenous infusion amiodarone was given and group B where oral propafenone was administrated. The effectiveness and the time needed for conversion of atrial fibrillation to sinus rhythm were compared in both groups. Results: The success of conversion of atrial fibrillation to sinus rhythm was 83% in group A and 85% in group B, p-value ¼ 0.699. The time elapsed from drug administration till conversion of atrial fibrillation was 9.07 ± 5.04 hours in group A versus 3.9 ± 1.54 hours in group B, p-value ¼ 0.001. In both groups, patients who showed failed conversion had a significantly larger left atrial diameter and a significantly higher high sensitivity C-reactive protein (hsCRP) level. Conclusion: Oral propafenone was faster than parenteral amiodarone in the conversion of recent onset atrial fibrillation to sinus rhythm. Patients with failed conversion had a bigger left atrial diameter and a higher hsCRP when compared to patients with successful conversion

Efficacy and influencing factors of Propafenone in acute treatment of paroxysmal supraventricular tachycardia in children / 中华实用儿科临床杂志

Objective:To explore the safety and efficacy of Propafenone in terminating paroxysmal supraventricular tachycardia (PSVT) in children and analyze the factors influencing the effectiveness.Methods:A retrospective study was conducted on 169 PSVT children treated with Propafenone in the Department of Pediatric Cardiology, Heart Center, the First Hospital of Tsinghua University from September 2014 to October 2021.There were 118 boys and 51 girls with an average age of (2.84±2.91) years (age range: 14 days-13 years). According to age, they were divided into ≤ 1-year-old group, >1-3-year-old group, >3-7-year-old group, and >7-year-old group.Mea-surement data were compared between groups using t-test and Mann- Whitney U test.Counting data were analyzed by χ2 test. Results:Among the 169 children with PSVT, 65 cases (38.5%) were below 1 year old, 47 cases (27.8%) were >1-3 years old, 40 cases (23.7%) were >3-7 years old, 17 cases (10.1%) were above 7 years old.About 24 cases (14.2%) were combined with congenital heart disease.A total of 153 cases (90.5%) had nonspecific symptoms at the first visit.A total of 4.1% (7/169 cases) were complicated with tachycardia-induced cardiomyopathy, and their left ventricular ejection fraction increased from (44.0±4.0)% to (53.7±6.9)% after successful control of PSVT ( t=-4.700, P=0.003). The complete termination of PSVT by intravenous Propafenone was achieved in 125 of 169 cases (74.0%, 125/169 cases). The complete termination rate after multiple times of administration (74.0%) was significantly higher than that after the first intravenous injection (53.3%, 90/169 cases) ( χ2=15.657, P<0.001). There was a significant difference regarding the complete termination rate between children ≤1 year old (60.0%, 39/65 cases) and those >1 year old (82.7%, 86/104 cases) ( χ2=10.696, P=0.001). For children ≤1 year old, 1.5 mg/kg Propafenone (51.1%, 23/45 cases) showed better efficacy for PSVT termination than 1.0 mg/kg Propafenone (20.0%, 4/20 cases) ( χ2=5.519, P=0.019). For children >1 year old, there was no significant diffe-rence between 1.5 mg/kg and 1.0 mg/kg Propafenone groups (57.9% vs.62.1%) ( χ2=0.180, P=0.671). The adverse reaction rate of intravenous Propafenone was 9.5% (16/169 cases). One case presented with severe hypotension, which occurred in a child with right cardiac insufficiency with tricuspid valve depression; 15 cases showed abnormal cardiac conduction and recovered spontaneously in a short time.There was no deterioration of cardiac function in children with mildly to moderately reduced cardiac function. Conclusions:It is relatively safe and effective to terminate PSVT in children with intravenous Propafenone.The complete termination rate is 74.0%, which is related to age, dose and times of administration.Despite of low incidence of side effects, Propafenone should not be used to treat PSVT with cardiac function which is significantly impaired or unclear secondary to persistent tachycardia.Special attention should be paid to cardiac function deterioration in these patients.

Detoxification effects of long-chain versus a mixture of medium- and long-chain triglyceride-based fat emulsion on propafenone poisoning

In the present study, we aimed to compare the detoxifying effects of two fat emulsions containing either long-chain triglyceride or a mixture of medium-chain and long-chain triglycerides in the propafenone-poisoned rat model. Rats were randomly divided into 3 groups according to the fat emulsions used: long-chain triglyceride-based fat emulsion (LL) group; medium-chain and long-chain triglyceride-based fat emulsion (ML) group; normal saline (NS) group. Propafenone was continuously pumped (velocity=70 mg/kg per h) until the mean blood pressure dropped to 50% of basal level. Then, LL/ML fat emulsions or NS was intravenously infused instantly with a loading-dose (1.5 mL/kg) and a maintenance dose (0.25 mL/kg per min) for 1 h. Subsequently, the propafenone was added to plasma (3.5 μg/mL) in vitro, mixed with three doses of LL or ML (1, 2, or 4%). Finally, after centrifugation, the concentration of propafenone was measured. Rats treated with LL exhibited accelerated recovery, characterized by higher blood pressure and heart rate. Rats in both the LL and ML groups demonstrated decreased propafenone in plasma (time-points: 15, 25, and 60 min). However, rats that received LL showed lower propafenone in myocardial tissue at the end of detoxification treatment. Rats in the ML group had the lowest value of pH, the minimum content of HCO3-, and the highest production of lactic acid at the end. In the in vitro experiments, propafenone decreased more dramatically in the LL group compared to the ML group. Long-chain triglyceride fat emulsion had a better effect on treating propafenone poisoning in rats.

Analysis on effect of using pre-hospital propafenone emergency treatment for rescuing patients with paroxysmal supraventricular tachycardia / 中国中西医结合急救杂志

Objective To observe the effect of propafenone for patients with paroxysmal supra-ventricular tachycardia (PSVT) during pre-hospital emergency rescue treatment. Methods A retrospective study was conducted. Seventy-six patients with occurrence of PSVT in the process of pre-hospital emergency treatment in Tianjin Hongqiao Hospital from March 2018 to March 2019 were selected. The patients were divided into amiodarone group and propafenone group according to the difference in medications, 38 cases in each group. The effective rate of rescue, the time of recovery of normal heart rate, the total time of treatment, the levels of heart rate before and after treatment and the incidence of adverse reactions were observed in both groups. Results The total effective rate of propafenone group was significantly higher than that of amiodarone group [94.74% (36/38) vs. 73.68% (28/38), P<0.05]. The times of recovery of normal heart rate and total treatment of propafenone group were significantly lower than those of amiodarone group [times of recovery of normal heart rate (hours): 7.14±1.84 vs. 12.56 ± 2.56, times of total treatment (days): 6.14 ± 2.20 vs. 8.87±2.48, both P<0.05].Before treatment, there was no statistical significant difference in heart rate between propafenone group and amiodarone group (hpm: 171.8 ± 24.4 vs. 173.7 ± 25.5, P>0.05), but after treatment, the heart rate of propafenone group was significantly lower than that in amiodarone group (hpm: 112.9±7.5 vs. 138.4 ± 9.0, P<0.05). The incidence of adverse reactions in propafenone group was significantly lower than that of amiodarone group [2.63% (1/38) vs. 15.79% (6/38), P<0.05]. Conclusion Application of propafenone in the pre-hospital emergency treatment of patients with PSVT can effectively improve their clinical efficacy, and its therapeutic safety is high.

Therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia and their safety / 心血管康复医学杂志

Objective :To compare therapeutic effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia (PSVT) and their safety .Methods : A total of 90 PSVT patients ,who were treated in our hospital from Jan 2013 to May 2018 ,were selected .Patients were randomly and equally divided into propafenone group and amio—darone group ,each group received corresponding medication based on routine treatment for 24h.Blood pressure , heart rate ,cardiac function indexes :LVEDV ,LVESV and LVEF before and after treatment ,cardioversion time , successful cardioversion rate within 60 min and incidence of adverse reactions during treatment were observed and compared between two groups .Results : There was no significant difference in successful cardioversion rate (propafenone group 91.11% vs.amiodarone group 93.33%, P＝1.000) between two groups .Compared with be—fore treatment ,on 24h after treatment ,there were significant reductions in blood pressure and heart rate in two groups , P＝0. 001 all ;but there was no significant difference between two groups before and after treatment , P＞0.05 all.Cardioversion time of propafenone group was significantly shorter than that of amiodarone group [ (12. 66 ± 2.06) min vs .(22. 80 ± 2.28 ) min ] , P＝ 0. 001 .Compared with propafenone group on 24h after treatment , there was significant rise in LVEF [ (63. 24 ± 3.67)% vs.(66. 83 ± 4.01)%] ,significant reductions in LVEDV [ (96.65 ± 5.24) ml vs.(92. 09 ± 4.37) ml] and LVESV [ (38.40 ± 2.87) ml vs.(30. 13 ± 7.34) ml] in amioda—rone group , P＝ 0. 001 all.Total incidence rate of adverse reactions in amiodarone group was significantly lower than that of propafenone group (8.89% vs.24. 44%) , P＝0. 048. Conclusion : Propafenone and amiodarone possess significant therapeutic effect on PSVT .Propafenone possesses shorter cardioversion time ,while amiodarone posses— ses less adverse reactions and improve cardiac function .Therefore ,medication should be selected properly according to patient′s specific condition in clinic .

Inhibition of voltage-dependent K⁺ current in rabbit coronary arterial smooth muscle cells by the class Ic antiarrhythmic drug propafenone

In this study, we demonstrated the inhibitory effect of the Class Ic antiarrhythmic agent propafenone on voltage-dependent K⁺ (Kv) channels using freshly isolated coronary artery smooth muscle cells from rabbits. The Kv current amplitude was progressively inhibited by propafenone in a dose-dependent manner, with an apparent IC₅₀ value of 5.04±1.05 µM and a Hill coefficient of 0.78±0.06. The application of propafenone had no significant effect on the steady-state activation and inactivation curves, indicating that propafenone did not affect the voltage-sensitivity of Kv channels. The application of train pulses at frequencies of 1 or 2 Hz progressively increased the propafenone-induced inhibition of the Kv current. Furthermore, the inactivation recovery time constant was increased after the application of propafenone, suggesting that the inhibitory action of propafenone on Kv current is partially use-dependent. Pretreatment with Kv1.5, Kv2.1 or Kv7 inhibitor did not change the inhibitory effect of propafenone on the Kv current. Together, these results suggest that propafenone inhibits the vascular Kv channels in a dose- and use-dependent manner, regardless of Na⁺ channel inhibition.

A retrospective analysis of cardioversion for paroxysmal supraventricular tachycardia in emergency department / 中华急诊医学杂志

Objective To analyze retrospectively the cardioversion for paroxysmal supraventricular tachycardia (PSVT) in emergency department in order to explore rational guidance for the diagnosis and treatment for PSVT.Methods A retrospective analysis of PSVT patients in the emergency department admitted from June 2015 to December 2015 was carried out.First,all the patients were divided into two groups according to the cardioversion achieved by Valsalva's maneuvre or not.Forty patients were enrolled in study.There were 11 patients got cardioversion successfully achieved by the Valsalva's maneuvre and 29 patients failed to get cardioversion.Then,comparisons of demographics,vital sign,serum CTNI,potassium and NTproBNP level were carried out between these groups of patients using statistical analysis.The categorical variable was expressed in percentage and the continuous variable was described by mean±standard deviation and the comparisons of parameters were conducted by group t-test and chi-square test.Results The success rate of PSVT maneuvre cardioversion was 27.5％.In addition,there were no significant differences in demographics vital sign,TNI and NTproBNP between the two groups while there were significant differences in serum potassium level between the two groups [(3.8±0.4)mmol/L vs.(3.5±0.35)mmol/L P＜0.05].There was no significant difference in successful rate of cardioversion between the standard Valsalva's maneuvre(n=6) the modified Valsalva's maneuvre(n=5).The second-line treatment mainly included propafenone,adenosine,electroversion,verapamil and amiodarone.The propafenone was the most common second-line agent used for PSVT cardioversion accounting for 58.6％.Conclusions The success rate of Valsalva's maneuver cardioversion was low.Keeping properly a higher level of serum potassium could increase the success rate of cardioversion by Valsalva's maneuvre.

Application of intravenous pump infusion of large dose amiodarone in paroxysmal atrial fibrillation / 心血管康复医学杂志

Objective:To study therapeutic effect of intravenous pump infusion of large dose amiodarone on paroxys-mal atrial fibrillation(PAF).Methods:A total of 128 PAF patients,who were treated in our hospital from Jan 2014 to Dec 2016,were selected.The patients were randomly and equally divided into propafenone group and amioda-rone group,both groups received corresponding therapy based on anticoagulant and basic treatment for six months. Fibrinogen(Fg),hematocrit(HCT),plasma viscosity(np),erythrocyte sedimentation rate(ESR),whole blood high shear viscosity(nbh)and whole blood low shear viscosity(nbl),QTc interval,PR interval and QRs wave dura-tion,levels of hsCRP,TNF-α and IL-6 before and six months after treatment were observed and compared between two groups.Results:Compared with before treatment,after six-month treatment,there were significant reductions in Fg,HCT,np,ESR,nbh,nbl,levels of hsCRP,TNF-α and IL-6,and significant rise in QTc interval in two groups,P=0.001 all.Compared with propafenone group after six-month treatment,there were significant reduc-tions in Fg[(357.48 ± 35.82)g/L vs.(318.83 ± 32.58)g/L],HCT[(44.68 ± 4.75)% vs.(32.44 ± 3.38)%],np [(1.74 ± 0.18)mPa·s vs.(1.15 ± 0.12)mPa·s],ESR[(18.82 ± 1.93)mm/h vs.(14.83 ± 1.52)mm/h],nbh [(5.22 ± 0.54)mPa·s vs.(4.05 ± 0.42)mPa·s],nbl[(8.68 ± 0.86)mPa·s vs.(7.18 ± 0.73)mPa·s],levels of hsCRP[(5.76 ± 0.59)μg/ml vs.(5.22 ± 0.54)μg/ml],TNF-α[(88.76 ± 10.43)ng/L vs.(55.16 ± 6.82)ng/L]and IL-6[(92.52 ± 10.44)ng/L vs.(60.75 ± 7.38)ng/L],and significant rise in QRc interval[(0.40 ± 0.05) s vs.(0.45 ± 0.07)s]in amiodarone group,P=0.001 all.Total effective rate of amiodarone group was significant-ly higher than that of propafenone group(90.63% vs.75.00%),P=0.019. There was no significant difference in total incidence rate of adverse reactions between two groups,P=0.818. Conclusion:Intravenous pump infusion of large dose amiodarone can significantly improve hemodynamics and QTc interval,reduce serum levels of inflamma-tory factors with significant therapeutic effect and reliable safety in PAF patients,which is worth extending.

Comparative study on the effects of different concentrations of Iopromide Injection on liver tissue imaging and adverse reactions / 中国生化药物杂志

Objective To investigate the effects of different concentrations of iopromide injection on liver tissue imaging and adverse reactions. Methods Selected 150 patients of liver without substantial disease patients, were randomly divided into A group (n=50) and B group (n=50) and C group (n=50), after the abdominal plain, Iopromide Injection injection enhanced scan of the abdominal aorta, portal vein, 5 hepatic tissue, strengthen the evaluation value and the adverse reactions were observed, compared with different concentrations of Iopromide Injection imaging effect and adverse reaction of liver tissue. Results A group was injected with 370 mg/mL Iopromide Injection after abdominal aorta was 249.21, the enhancement of portal vein was 132, B group were injected with 350 mg/mL value of 229.32 Iopromide Injection portal vein enhancement, portal vein enhancement value was 121.32, C group were injected with 300 mg/mL Iopromide Injection hepatic enhancement value was 239.21, the enhancement of portal vein was 98.32, the A group and B group, there was significant difference with C group (P<0.05). There was no significant difference in adverse reactions between the three groups when injected with different concentrations of iopromide injection. Conclusion The results show that the imaging effect is better with the increase of concentration, and there is no significant difference between the patients with high concentration contrast agent and low concentration contrast agent.

Comparative study on the effects of different concentrations of Iopromide Injection on liver tissue imaging and adverse reactions / 中国生化药物杂志

Objective To investigate the effects of different concentrations of iopromide injection on liver tissue imaging and adverse reactions. Methods Selected 150 patients of liver without substantial disease patients, were randomly divided into A group (n=50) and B group (n=50) and C group (n=50), after the abdominal plain, Iopromide Injection injection enhanced scan of the abdominal aorta, portal vein, 5 hepatic tissue, strengthen the evaluation value and the adverse reactions were observed, compared with different concentrations of Iopromide Injection imaging effect and adverse reaction of liver tissue. Results A group was injected with 370 mg/mL Iopromide Injection after abdominal aorta was 249.21, the enhancement of portal vein was 132, B group were injected with 350 mg/mL value of 229.32 Iopromide Injection portal vein enhancement, portal vein enhancement value was 121.32, C group were injected with 300 mg/mL Iopromide Injection hepatic enhancement value was 239.21, the enhancement of portal vein was 98.32, the A group and B group, there was significant difference with C group (P<0.05). There was no significant difference in adverse reactions between the three groups when injected with different concentrations of iopromide injection. Conclusion The results show that the imaging effect is better with the increase of concentration, and there is no significant difference between the patients with high concentration contrast agent and low concentration contrast agent.

Curative Efficacy of Wenxin Granule Combined with Propafenone in Treatment of Arrhythmia and Serum Levels of hs-CRP, TNF-α and IL-6 and Heart Function / 现代生物医学进展

Objective:To study the curative efficacy of wenxin granule combined with propafenone in the treatment of arrhythmia and its effects on the serum levels ofhs-CRP,TNF-α,IL-6 and heart function.Methods:96 patients of arrhythmia who were treated from July 2014 to October 2016 in our hospital were selected and randomly divided into the observation group (n=48) and the control group (n=48).The control group was treated with propafenone,while the observation group was treated with wenxin granuleon.Then the serum levels of hs-CRP,TNF-α and IL-6,heart function,clinical efficacy and incidence of adverse reactions were observed and compared between the two groups before and after the treatment.Results:After treatment,the total effective rate of observation group was significantly higher than that of the control group (P＜0.05).The serum levels of hs-CRP,TNF-α and IL-6 of observation group were significantly lower than those of the control group (P＜0.05);the left ventricular end diastolic dimension (LVEDD) and left ventricular end systolic diameter (LVESD) of observation group were significantly lower than those of the control group,and the left ventricular ejection fraction (LVEF) was significantly higher than that of control group(P＜0.05);the incidence of adverse reactions in the observation group was significantly lower than that of the control group (P＜0.05).Conclusion:Wenxin granule combined with propafenone was effective for arrhythmia,it could effectively improve the heart function and high safety,which might be related to the decrease of serum hs-CRP,TNF-and IL-6 levels.

Bioequivalência de cloridrato de propafenona 300mg em comprimido revestido em administração pós-prandial em adultos saudáveis / Bioequivalence of propafenone hydrochloride 300mg film coated tablets in healthy adults

OBJETIVO: Avaliar a bioequivalência de duas formulações de cloridrato de propafenona 300mg em comprimido revestido.MÉTODOS: Estudo randomizado, cruzado, aberto, com dois tratamentos, duas sequências e quatro períodos com 60 participantes sadios de ambos os sexos. Os voluntários foram internados em quatro oportunidades durante 24 horas; em cada período, os sujeitos receberam a formulação teste ou a formulação referência, em regime pós-prandial. Foram coletadas 23 amostras de sangue após administração da droga para determinação plasmática da propafenona. Para quantificação da droga, foi utilizada técnica de cromatografia líquida acoplada à espectrometria de massas sequencial. RESULTADOS: As formulações foram consideradas clinicamente bem toleradas. A concentração máxima e a área sob a curva de zero a 36 horas foram comparadas: a média geométrica da razão entre as formulações teste e referência para concentração máxima foi de 110,16%, com intervalo de confiança de 99,44% a 122,04% e coeficiente de variação de 33,95%. A média geométrica da razão entre as formulações teste e referência para a área sob a curva de zero a 36 horas foi de 107,92%, com intervalo de confiança de 99,58% a 116,96% e coeficiente de variação de 26,39%. A média geométrica da razão entre o medicamento teste e referência para área sob a curva de zero ao infinito foi de 107,12%, com intervalo de confiança de de 99,11% a 115,78% e coeficiente de variação de 25,48%. CONCLUSÃO: As formulações teste e referência foram estatisticamente bioequivalentes, de acordo com sua taxa e extensão de absorção.

OBJECTIVE: To evaluate the bioequivalence of two 300mg profanone hydrochloride coated tablets. METHODS: Randomized, cross-over, openstudy, with two treatments, two sequences, and four periods with 60 healthy participants of both genders. The volunteers were admitted in four opportunities over 24 hours; on each period, the subjects received a test formulation, or a reference formulation, in a postprandial administration. Twenty-three samples of blood were collected after oral administration of the drug for determining plasma level of propafenone. Liquid chromatography-mass spectrometry was used for quantifying propafenone. RESULTS: The formulations were considered clinically well tolerated. The maximum concentration and the area under the curve from zero to 36 hours were compared: the geometric mean of the ratio between the test and reference formulations for maximum concentration was 110.16%, with confidence interval of 99.44% - 122.04%), coefficient of variation of 33.95%. The geometric mean of the ratio between the test and reference formulations for the area under the curve of zero to 36 hours was 107.92%, with confidence interval of 99.58% - 116.96%, and coefficient of variation of 26.39%. The geometric mean of the ratio between the formulations for area under the curve of zero to infinitum as 107.12% with confidence interval of 99.11% - 115.78%),and coefficient of variation of 25.48%. CONCLUSION: According to the rate and extension of absorption, the test and reference formulations are statistically bioequivalent.

Amiodarone Versus Propafenone to Treat Atrial Fibrillation after Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial

BACKGROUND: Atrial fibrillation (AF) is one of the most common complications after cardiac surgery. Several therapeutic and preventive strategies have been introduced for postoperative AF, but the treatment and prophylaxis of AF remain controversial. We aimed to compare the efficacy of intravenous amiodarone and oral propafenone in the treatment of AF after coronary artery bypass grafting (CABG). METHODS: This was a randomized controlled trial performed in two hospitals in Shiraz, Iran from 2009 to 2012. We included all patients who underwent elective CABG and developed AF postoperatively. The patients were randomly assigned to receive propafenone or amiodarone. The duration of AF, the success rate of the treatment, the need for cardioversion, the frequency of repeated AF, and the need for repeating the treatment were compared. RESULTS: The duration of the first (p=0.361), second (p=0.832), and third (p=0.298) episodes of AF, the need for cardioversion (p=0.998), and the need to repeat the first and second doses of drugs (p=0.557, 0.699) were comparable between the study groups. Repeated AF was observed in 17 patients (30.9%) in the propafenone group and 23 patients (34.3%) in the amiodarone group (p=0.704). CONCLUSION: Oral propafenone and intravenous amiodarone are equally effective in the treatment and conversion of recent-onset AF after CABG.

Clinical effect of propafenone and amiodarone on paroxysmal supraventricular tachycardia / 中国生化药物杂志

Objective To investigate the comparison of the clinical treatment efficacy of propafenone and amiodarone in patients with paroxysmal supraventricular tachycardia ( PSVT ) .Methods Retrospective a total of 89 patients with PSVT from June 2013 to June 2015 in our hospital were selected.According to the different administration methods, the patients were divided into the propafenone group of 46 cases and the amiodarone group of 43 cases.The changes of left ventricular end-systolic volume, left ventricular end-diastolic volume, ejection fraction, cardioversion success rate, mean cardioversion time, heart rate and side effects were compared.Results After treatment, the left ventricular end-systolic volume (52.31 ±8.34) mL/m2 , (54.28 ±7.23) mL/m2, left ventricular end-diastolic volume (47.31 ±8.56) mL/m2, (45.28 ±7.16) mL/m2 and ejection fraction (61.57 ± 0.76)%, (61.39 ±0.69)% were without significant differences.After treatment, the heart rates of the two groups were significantly decreased, the propafenone group ( 85.31 ±12.84 ) times/min, amiodarone group ( 87.26 ±11.95 ) times/min, and there were not significant differences.The recovery time of propafenone group was ( 19.34 ±4.76 ) , higher than the amiodarone group ( 25.69 ±6.09 ) ( P <0.05 ).But the success rate of cardioversion (52.17%) was lower than the amiodarone group (88.37%) (P<0.05).The side effect rates in the propafenone group (21.74%) was significantly higher than that in the amiodarone group ( 4.65%) ( P <0.05 ) .Conclusion Propafenone and amiodarone cardioversion PSVT have achieved good results, but propafenone rapid onset, the average cardioversion time is short, which is only suitable for acute tachycardia and without serious organic heart disease patients.Amiodarone onset is slower,but the cardioversion success rate is higher.

Flutter atrial fetal ? relato de caso e discussão terapêutica / Fetal atrial flutter ? case report and therapeutic discussion

A taquicardia fetal ocorre em 0,4-0,6% de todas as gestações. Das taquiarritmias fetais sustentadas, o flutter atrial é a segunda mais comum. Quando não tratada corretamente, causa insuficiência cardíaca fetal e pode ser necessária a interrupção precoce da gestação. O diagnóstico das taquiarritmias é feito, principalmente, pela ecocardiografiaintraútero. O tratamento de primeira escolha é a administração oral materna de digoxina. Caso não haja resposta adequada ou o feto evolua com hidropisia, é necessário associar outro antiarrítmico como sotalol ou amiodarona. Neste relato, iniciou-se com digoxina; e, em função da ausência de resposta, foi associada propafenona. Sotalol ou amiodarona não foram usados devido à bradicardia e à hipotensão materna.

Fetal tachycardia occurs in 0.4 - 0.6% of all pregnancies. Out of the sustained fetal tachyarrhythmias, the atrial flutter is the second most common. It causes fetal heart failure when not properly treated, and early pregnancy interruption may be required. The diagnosis of tachyarrhythmias is mainly achieved by intra-uterus echocardiography. The first choice treatment is the maternal oral administration of digoxin. The association with other antiarrhythmics such as sotalol or amiodarone is needed if there is no response to digoxin or if the fetus evolves with dropsy. In this case report, the treatment began with digoxin and because there was no response, it was associated with propafenone. Sotalol or amiodarone were not used due to maternal bradycardia and hypotension.

Pharmacokinetics of propafenone hydrochloride sustained-release capsules in male beagle dogs

This paper describes the development and validation of a liquid chromatography-mass spectrometric assay for propafenone and its application to a pharmacokinetic study of propafenone administered as a new propafenone hydrochloride sustained-release capsule (SR-test), as an instant-release tablet (IR-reference) and as the market leader sustained-release capsule (Rythmol, SR-reference) in male beagle dogs (n=8). In Study A comparing SR-test with IR-reference in a crossover design T max and t 1/2 of propafenone for SR-test were significantly higher than those for IR-reference while C max and AUC were lower demonstrating the sustained release properties of the new formulation. In Study B comparing SR-test with SR-reference the observed C max and AUC of propafenone for SR-test (124.5±140.0 ng/mL and 612.0±699.2 ng·h/mL, respectively) were higher than for SR-reference (78.52±72.92 ng/mL and 423.6±431.6 ng·h/mL, respectively) although the differences were not significant. Overall, the new formulation has as good if not better sustained release characteristics to the market leader formulation.

Comparison of Clinical Efficacy and Safety of Amiodarone and Propafenone in the Treatment of Chronic Atri-al Fibrillation Cardioversion / 中国药房

OBJECTIVE:To compare the clinical efficacy and safety of amiodarone and propafenone in the treatment of chron-ic atrial fibrillation cardioversion. METHODS:60 patients with chronic atrial fibrillation cardioversion were randomly divided into propafenone group and amiodarone group. All patients were given conventional treatment,including treating primary disease,con-trolling symptoms,orally giving aspirin,intravenous infusion of GIK,monitoring heart rate,QT interval,P-R interval,QRS time,serum potassium and serum magnesium,etc. On this basis,propafenone group was orally given propafenone 450 mg for con-tinuous 3 months,3 times a day,and then the dose was decreased to 300 mg to maintain the sinus rhythm;amiodarone group was orally given amiodarone 200 mg for continuous 7 d a month,twice a day,and then the dose was decreased to 200 mg or 100 mg to maintain the sinus rhythm. The clinic data in 2 groups was observed,including clinical efficacy,simple drug cardioversion,elec-trical cardioversion,electrical cardioversion power,hospitalization time and incidence of adverse reactions,and the recurrence rate in 48 months was followed up. RESULTS:There were no significant differences in the clinical efficacy,simple drug cardiover-sion,electrical cardioversion,electrical cardioversion power,hospitalization time,incidence of adverse reactions and recurrence rate between 2 groups(P>0.05). CONCLUSIONS:Based on the conventinal treatment,amiodarone and propafenone have similar clinical efficacy and safety in the treatment of chronic atrial fibrillation cardioversion,and both of them can be used as the conven-tional drugs for treating chronic atrial fibrillation cardioversion.

Therapeutic effect of intravenous injection of propafenone on paroxysmal supraventricular tachycardia / 心血管康复医学杂志

Objective:To explore therapeutic effect of intravenous injection of propafenone on patients with paroxys‐mal supraventricular tachycardia (PSVT) and its safety .Methods :A total of 80 PSVT patients ,who were treated in our department of cardiology from Mar 2009 to Feb 2014 ,were selected .According to random number table meth‐od ,they were randomly and equally divided into propafenone group (received propafenone intravenously) and amio‐darone group (received amiodarone intravenously) .Heart rate ,cardioversion time ,clinical total effective rate and incidence rates of adverse reactions were recorded and compared between two groups before and 24h after treat‐ment .Results:There was no significant difference in total effective rate between two groups , P>0.05. Compared with amiodarone group ,there were significant reductions in cardioversion time [ (18.9 ± 3.2) min vs .(7.3 ± 1.0) min] , heart rate after treatment 24 h [ (99.6 ± 8.4) beats/min vs .(81.2 ± 5.9) beats/min] in propafenone group , P<0.05 both .Conclusion:Intravenous injections of propafenone and amiodarone possess similar therapeutic effect on paroxysmal supraventricular tachycardia ,but propafenone can achieve rapid cardioversion and reduce heart rate with satisfying safety ,which is worth further extending .