Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation
Background. According to present 2016–2017 recommendations, propafenone and amiodarone are the main antiarrhythmic medications (AAM) for medicamentous sinus rhythm (SR) restoration. Direct effectiveness and safety comparison of these medications injectable forms for atrial fibrillation (AF) paroxysm...
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doaj-cd00e93aa49d42b1a7c5b8573877b7212021-08-02T18:03:25ZrusZAO "Consilium Medicum"Consilium Medicum2075-17532542-21702019-01-01211818610.26442/20751753.2019.1.190286Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillationAleksei V. Tarasov0Sergei A. Kosykh1Elena V. Bushueva2Karapet V. Davtyan3Olga N. Miller4National Medical Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 10, 3, Petroverigskii ln., Moscow, 101990, Russian FederationMoscow Regional Ambulance Station. 3, Znamenskaia st., Krasnogorsk, Moscow region, 143405, Russian FederationL.A.Vorokhobov City Clinical Hospital №67. 2/44, Saliama Adilia st., Moscow, 123423, Russian FederationNational Medical Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation. 10, 3, Petroverigskii ln., Moscow, 101990, Russian FederationNovosibirsk State Medical University of the Ministry of Health of the Russian Federation. 52, Krasnyi dr., Novosibirsk, 630091, Russian Federation Background. According to present 2016–2017 recommendations, propafenone and amiodarone are the main antiarrhythmic medications (AAM) for medicamentous sinus rhythm (SR) restoration. Direct effectiveness and safety comparison of these medications injectable forms for atrial fibrillation (AF) paroxysm treatment on pre-hospital stage is one of the pressing issues. Aim. To compare effectiveness and safety of propafenone and amiodarone use in urgent SR restoration in patients with paroxysmal AF on pre-hospital stage. Materials and methods. An open randomized multicenter prospective study PROMETEI-INSK was conducted. The study included 388 patients with AF paroxysm with mean lasting time of 195 minutes. For the purpose of AF paroxysm treatment amiodarone intravenous bolus was used, in group 2 (268 patients) – propafenone intravenous bolus. The compared groups were matched by sex, age, electrocardiogram (ECG) parameters, and anamnesis of arrhythmic events, comorbid pathology, and therapy. The following investigations were performed: physical examination, medical history taking, ECG before and after rhythm restoration, as well as basic vital factors evaluation (such as heartbeat rate, blood pressure). Study results were processed with the use of statistical data analysis software package Statistica 10 for Windows (StatSoft Inc., USA). Results. AAM effectiveness was evaluated for 24 hours until SR restoration. In the group 1 (amiodarone use) the effectiveness was 61.7% (n=74), in group 2 (propafenone) – 77.6% (n=208); p<0.05. The mean time of rhythm restoration in group 1 was 110 minutes, in group 2 – 22 minutes (p<0.05). Relief of AF paroxysm happened in less than 60 minutes in 25.83% (n=31) of patients in group 1, and in 64.5% (n=173) in group 2; p<0.05. There were no significant differences observed in proarrhythmic and other adverse effects. Conclusion. Propafenone in injectable form is an effective and safe AAM in AF paroxysmal form treatment in comparison with amiodarone on pre-hospital stage. In patients with AF who have no changes in cardiac structure amiodarone is not a first line drug for emergency management of recently emerged AF.http://consilium.orscience.ru/en/archive/2019/vol-21-1-2019/comparison-of-antiarrhythmic-medications-propafenone-and-amiodarone-injection-forms-effectiveness-in_5098/?elementPROMETEI-INSKatrial fibrillation paroxysmal formmedicamentous cardioversionantiarrhythmic medicationspropafenoneamiodarone |
collection |
DOAJ |
language |
Russian |
format |
Article |
sources |
DOAJ |
author |
Aleksei V. Tarasov Sergei A. Kosykh Elena V. Bushueva Karapet V. Davtyan Olga N. Miller |
spellingShingle |
Aleksei V. Tarasov Sergei A. Kosykh Elena V. Bushueva Karapet V. Davtyan Olga N. Miller Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation Consilium Medicum PROMETEI-INSK atrial fibrillation paroxysmal form medicamentous cardioversion antiarrhythmic medications propafenone amiodarone |
author_facet |
Aleksei V. Tarasov Sergei A. Kosykh Elena V. Bushueva Karapet V. Davtyan Olga N. Miller |
author_sort |
Aleksei V. Tarasov |
title |
Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
title_short |
Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
title_full |
Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
title_fullStr |
Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
title_full_unstemmed |
Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
title_sort |
comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation |
publisher |
ZAO "Consilium Medicum" |
series |
Consilium Medicum |
issn |
2075-1753 2542-2170 |
publishDate |
2019-01-01 |
description |
Background. According to present 2016–2017 recommendations, propafenone and amiodarone are the main antiarrhythmic medications (AAM) for medicamentous sinus rhythm (SR) restoration. Direct effectiveness and safety comparison of these medications injectable forms for atrial fibrillation (AF) paroxysm treatment on pre-hospital stage is one of the pressing issues.
Aim. To compare effectiveness and safety of propafenone and amiodarone use in urgent SR restoration in patients with paroxysmal AF on pre-hospital stage.
Materials and methods. An open randomized multicenter prospective study PROMETEI-INSK was conducted. The study included 388 patients with AF paroxysm with mean lasting time of 195 minutes. For the purpose of AF paroxysm treatment amiodarone intravenous bolus was used, in group 2 (268 patients) – propafenone intravenous bolus. The compared groups were matched by sex, age, electrocardiogram (ECG) parameters, and anamnesis of arrhythmic events, comorbid pathology, and therapy. The following investigations were performed: physical examination, medical history taking, ECG before and after rhythm restoration, as well as basic vital factors evaluation (such as heartbeat rate, blood pressure). Study results were processed with the use of statistical data analysis software package Statistica 10 for Windows (StatSoft Inc., USA).
Results. AAM effectiveness was evaluated for 24 hours until SR restoration. In the group 1 (amiodarone use) the effectiveness was 61.7% (n=74), in group 2 (propafenone) – 77.6% (n=208); p<0.05. The mean time of rhythm restoration in group 1 was 110 minutes, in group 2 – 22 minutes (p<0.05). Relief of AF paroxysm happened in less than 60 minutes in 25.83% (n=31) of patients in group 1, and in 64.5% (n=173) in group 2; p<0.05. There were no significant differences observed in proarrhythmic and other adverse effects.
Conclusion. Propafenone in injectable form is an effective and safe AAM in AF paroxysmal form treatment in comparison with amiodarone on pre-hospital stage. In patients with AF who have no changes in cardiac structure amiodarone is not a first line drug for emergency management of recently emerged AF. |
topic |
PROMETEI-INSK atrial fibrillation paroxysmal form medicamentous cardioversion antiarrhythmic medications propafenone amiodarone |
url |
http://consilium.orscience.ru/en/archive/2019/vol-21-1-2019/comparison-of-antiarrhythmic-medications-propafenone-and-amiodarone-injection-forms-effectiveness-in_5098/?element |
work_keys_str_mv |
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