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Propafenone Treatment of Symptomatic Paroxysmal Supraventricular Arrhythmias: A Randomized, Placebo-Controlled, Crossover Trial in Patients Tolerating Oral Therapy

Edward L.C. Pritchett, MD; Elizabeth A. McCarthy, RN; and William E. Wilkinson, PhD
[+] Article, Author, and Disclosure Information

Grant Support: In part by a grant from Knoll Pharmaceutical Company and by grant RO1 HL40392 from the National Heart, Lung and Blood Institute, Bethesda, Maryland, and grant M01 RR30 from the National Center for Research Resources, National Institutes of Health, Bethesda, Maryland.

Current Author Addresses: Dr. Pritchett and Ms. McCarthy: Box 3477, Duke University Medical Center, Durham, NC 27710.

Dr. Wilkinson: Box 2914, Duke University Medical Center, Durham, NC 27710.

©1991 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1991;114(7):539-544. doi:10.7326/0003-4819-114-7-539
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Objective: To test the hypothesis that propafenone, administered orally, prevents symptomatic paroxysmal supraventricular arrhythmias.

Design: A 6-month, open-label, dose-finding phase followed by a randomized, double-blind, placebo-controlled, crossover phase, with each treatment period lasting up to 60 days.

Setting: An outpatient clinic.

Patients: Thirty-three patients with either paroxysmal supraventricular tachycardia (n = 16) or paroxysmal atrial fibrillation (n =17) were enrolled. Their arrhythmias were documented by electrocardiogram before enrollment. Twenty-three patients (14 with paroxysmal supraventricular tachycardia and 9 with paroxysmal atrial fibrillation) were randomized and the data obtained from these patients were used in the efficacy analysis.

Intervention: Propafenone (300 mg three times daily in 19 patients, 300 mg twice daily in 3 patients, and 150 mg twice daily in 1 patient) and matching placebo tablets were administered in a randomized sequence. Measurements: Symptomatic arrhythmia was documented by telephone transmission of the electrocardiogram.

Main Results: The time to first recurrence was prolonged for the overall group of 23 patients while they received propafenone (P =0.004). The recurrence rate of arrhythmia during treatment with propafenone was estimated to be approximately one fifth of the recurrence rate during treatment with placebo.

Conclusions: Propafenone is effective in reducing symptomatic paroxysmal supraventricular arrhythmias.





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