Predictors of Spontaneous Conversion of Recent Onset Atrial Fibrillation to Sinus Rhythm and the Long-term Maintenance of Sinus Rhythm with Propafenone [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. 2003; 31(7): 392-399

Predictors of Spontaneous Conversion of Recent Onset Atrial Fibrillation to Sinus Rhythm and the Long-term Maintenance of Sinus Rhythm with Propafenone

Abdullah Doğan1, Oktay Ergene1, Cem Nazlı1, Ozan Kınay1, Mustafa Öztürk2, Ahmet Altınbaş1, Ülkü Ergene3, Ömer Gedikli1, Yeşim Hoşcan1
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We investigated predictors of spontaneous conversion of recent onset atrial fibrillation (AF) to sinus rhythm (SR) and the long-term efficacy of propafenone for maintaining SR after conversion in patients with the first episode of recent AF. This prospective study consisted of consecutive 102 patients with recent onset AF (?48 hours). Twenty-four patients were excluded due to acute coronary syndome (n:17), heart failure (n:5) and pulmonary disease (n:2). The remaining 78 patients constituted the main study population. After spontaneous conversion to SR within 12 hours, they were randomized to propafenone (n:21, mean age:59.9 ±11.4 years) or placebo groups (n:24, mean age: 62.7±9.5 years) and were followed up for long-term SR maintenance during 12 months. There was no withdrawal at follow-up. Clinical characteristics in both groups were comparable. The maintenenance of SR was analyzed by the Kaplan-Meier method. Spontaneous SR was observed in 45 (58%) of 78 patients. Among the variables of age, gender, underlying heart disese, AF duration, left atrial dimension (LAD) and left ventricular ejection fraction (LVEF), duration of AF ?24 hours was the only independent predictor of spontaneous conversion in multivariate analysis (OR:7.1, 95% CI:1.6-31.3; p=0.01). At 12 months, SR was maintained in 16 (76%) patients assigned to the propafenone group whereas it was so in those 10 (42%) assigned to placebo (p=0.02). By multivariate analysis, treatment with propafenone was the only predictor for maintenance of SR (p=0.02) in a model comprising age, gender, underlying heart disese, AF duration, LAD and LVEF had no predictive value. No major side effects occurred. Patients with recent onset AF should be monitored for at least 12 hours to observe spontaneous conversion as long as hemodynamics are stable. Propafenone seems to be superior to placebo for long-term maintenance of SR after spontaneous conversion.

Keywords: Atrial fibrillation, propafenone, spontaneous conversion

How to cite this article
Abdullah Doğan, Oktay Ergene, Cem Nazlı, Ozan Kınay, Mustafa Öztürk, Ahmet Altınbaş, Ülkü Ergene, Ömer Gedikli, Yeşim Hoşcan. Predictors of Spontaneous Conversion of Recent Onset Atrial Fibrillation to Sinus Rhythm and the Long-term Maintenance of Sinus Rhythm with Propafenone. Turk Kardiyol Dern Ars. 2003; 31(7): 392-399
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