负荷量普罗帕酮转复新近发生的心房颤动疗效分析

目的 研究口服负荷量普罗帕酮转复新近发生的非瓣膜病、非冠心病心房颤动(房颤)的临床疗效和安全性。方法 有症状就诊的房颤患者89例,最近房颤持续发作在48h以内,既往无心力衰竭表现及其他心外病症,并排除瓣膜心脏病、冠心痛、甲状腺功能亢进症、病态窦房结综合征和肝肾功能损害。随机分为普罗帕酮组和毛花甙C组。普罗帕酮组一次顿服普罗帕酮负荷量450mg,2例体重<45kg患者给予300mg,4例体重>80kg患者给予600mg。毛花甙C组静推西地兰0.4mg,4h后仍为心房纤颤则追加0.2mg。密切观察患者心律、速率、血压、症状等变化,记录从给药到房颤转复的时间及转复瞬间心电图情况。比较二组患者4h和8h内房颤转复率及转复时间。结果 普罗帕酮组共45例,其中4h内转复23例(51.1％),平均转复时间为(1.5±0.3)h。毛花甙C组共44例,其中4h内转复11例(25.0％),平均转复时间为(2.9±0.7)h。4h内普罗帕酮组房颤转复率明显高于毛花甙C组(P<0.05),4h内平均转复时间亦有明显差异(P<0.01)。结论对于新近(≤48h)发生的不伴有心功能不全、冠心病、瓣膜性心脏病的房颤,口服负荷量的普罗帕酮是一种快速、简便、安全的转复方法。     

口服负荷量普罗帕酮转复新近发生的心房颤动

目的研究口服负荷量普罗帕酮转复新近发生的非瓣膜病心房颤动(房颤)的临床疗效和安全性.方法有症状就诊的房颤患者61例,最近房颤持续发作在48h之内,既往无心力衰竭表现,本次发作不伴急性心肌缺血和其他急性心外病症,临床排除心脏瓣膜病、预激综合征、病态窦房结综合征及甲状腺机能亢进.随机分为口服负荷量普罗帕酮组和静脉毛花甙C组.普罗帕酮组顿服负荷量普罗帕酮450mg(2例体重过轻者给以300mg).毛花甙C组采用0.4mg静脉小壶滴人,若4h仍未转复则追加0.2mg.所有患者均在心电监护下观察心电、血压及症状变化,记录从服药到转复为窦律的时间.比较两组4h和8h的转复率和转复时间.结果普罗帕酮组共31例,4h转复17例(54.8%),平均转复时间(1.6±0.2)h;4～8h转复6例(19.4%),未转复成功8例的房颤持续时间明显长于转复成功者(P<O.01),未发现明显副作用.静脉毛花甙c组共30例,4h内转复8例(26.7%),平均转复时间(2.7±0.9)h;4～8h转复5例(16.7%).两组比较4h内普罗帕酮组房颤转复率明显高于毛花甙c组(P<0.05),4h内的平均转复时间亦有明显差异(P<O.01).结论对于新近发生的(持续发作48h之内)、不伴心功能不全和急性心肌缺血及其他急性心外病症的非瓣膜病房颤患者,口服负荷量普罗帕酮是一个快速、方便、安全的转复方法.     

静脉普罗帕酮和毛花甙C转复阵发性非瓣膜病心房颤动

目的　对比普罗帕酮和毛花甙C在转复阵发性非瓣膜病心房颤动 (房颤 )的作用。方法　房颤发作在 0 5～ 72小时的患者 ,随机分入普罗帕酮组和毛花甙C组。静脉推注毛花甙C 0 4～ 0 6mg或普罗帕酮 70～ 2 10mg ,观察房颤转复情况及心室率的变化。 结果　共 70例患者 ,阵发性房颤病程 ( 2 8 2± 4 2 0 )个月。毛花甙C组 3 4例 ,转复成功 15例 ( 4 4 1% ) ;普罗帕酮组 3 6例 ,转复成功 2 8例 ( 77 8% ) ;P <0 0 1。转复成功时间 :毛花甙C组 ( 86 1± 5 3 5 )分钟 ,普罗帕酮组 ( 4 7 6±3 7 7)分钟 ,P =0 0 5 ;未转复成功者的心室率下降情况 :毛花甙C组由 ( 12 4 6± 2 0 3 )次 /min降至( 93 1± 19 2 )次 /min ,普罗帕酮组由 ( 12 4 0± 3 2 1)次 /min降至 ( 118 6± 2 1 0 )次 /min ,P >0 1。结论　在阵发性房颤的转复中静脉普罗帕酮的成功率高于毛花甙C ,普罗帕酮转复时间较毛花甙C短 ,而毛花甙C在减慢心室率方面优于普罗帕酮。     

口服普罗帕酮转复心房颤动疗效分析

目的：研究口服普罗帕酮转复新近发生的非瓣膜病、非冠心病心房颤动的临床疗效和安全性。方法：有症状就诊的房颤患者59例,房颤持续发作≤48h,既往无心力衰竭表现,并排除瓣膜心脏病、冠心病、甲状腺功能亢进症、病态窦房结综合征和肝、肾功能损害。随机分为普罗帕酮组(30例)和毛花苷 C 组(29例)。普罗帕酮组一次顿服普罗帕酮600 mg。毛花苷 C 组静推西地兰0.4mg,4h 后仍为心房纤颤则追加0.2mg。比较两组患者4h 和8h 房颤转复率及转复时间。结果：普罗帕酮组4h 内转复16例(53.3%),平均转复时间为(1.5±0.3)h。毛花苷 C 组29 例,4h 内转复7例(24.1%),平均转复时间为(2.9±0.7)h,普罗帕酮组更优(P 分别＜0.05,＜0.01),亦未发生严重副作用。结论：对于新近(≤48h)发生的不伴有心功能不全、冠心病、瓣膜性心脏病的房颤,口服负荷量的普罗帕酮是一种快速、简便、安全的转复方法。     

普罗帕酮转复新近发生心房颤动55例临床体会

目的通过观察口服负荷量普罗帕酮转复新近发生的非瓣膜性心房颤动的临床疗效,研究应用口服负荷量普罗帕酮转复新近发生心房颤动的可选择性及安全性。方法入选55例心电图证实为心房颤动病人,给予顿服普罗帕酮300mg,观察其疗效及转复的时间及副反应。结果21例病人4h内转复,8例病人4h～8h内转复,8h内共转复29例(52.7%),心房颤动发作时间越长,转复率越低。结论对于新近发生的非瓣膜性心房颤动病人,口服负荷量普罗帕酮是一种安全有效的复律方式。     

普罗帕酮转复慢性心房颤动的研究

目的：比较普罗帕酮、洋地黄转复慢性心房颤动(房颤)的作用。方法：房颤发作时间大于3周的患被随机分为普罗帕酮组(45例)和洋地黄组(44例)，普罗帕酮组先静脉推注普罗帕酮2mg／kg，再以5mg／kg维持24小时，后改口服，每天450mg，治疗4周。洋地黄组先静脉推注毛花甙C0．4mg，然后每6小时静脉推注0．2mg，24小时后改口服地高辛，每日0．25mg。结果：普罗帕酮组22例(48．9％)转复为窦性心律，洋地黄组仅3例(6．8％)转复成功。普罗帕酮组转复成功与末转复相比，房颤持续时间较短(P＜0．001)，左房内径明显较小(P＜0．010)。结论：普罗帕酮可有效地用于慢性房颤的转复，洋地黄转复慢性房颤疗效不佳。     

普罗帕酮及稳心颗粒治疗心房颤动疗效观察

目的　研究口服负荷量普罗帕酮及稳心颗粒对阵发性心房颤动的临床并疗效及安全性。方法　选择最近房颤持续发作48h之内临床排除心脏瓣膜病、甲状腺功能亢进、肥厚梗阻性心肌病、急性心肌梗死、不稳定型心绞痛、预激综合征、病态窦房结综合征、孕妇、心功能 1级～ 2级病人 ,共 5 8例 ,随机分为口服普罗帕酮、稳心颗粒组 (治疗组 )和静脉注射毛花甙丙组 (对照组 ) ;治疗组口服普罗帕酮、稳心颗粒 ,口服负荷量普罗帕酮 3 5 0mg～ 45 0mg ,稳心颗粒 9g ,每日 3次。对照组静脉输注毛花甙丙 0 .4mg ,两组随访 4周 ,比较转复率、复发率、安全性。结果　治疗组 3 0例 ,转复 2 2例 (73 .3 % ) ,复发 2例 (9% ) ,未发现明显副反应 ;对照组 2 8例 ,转复 14例 (5 0 .0 % ) ,复发 4例 (3 5 .7% )。结论　普罗帕酮是疗效较好、安全性较高的治疗阵发性房颤的药物 ,口服稳心颗粒对预防阵发性房颤可能有一定疗效     

胺碘酮和毛花甙C转复阵发性心房颤动及 心房扑动疗效的比较

目的对比胺碘酮和毛花甙C治疗阵发性心房颤动(房颤)及心房扑动(房扑)的疗效。方法阵发性房颤及房扑发作1～72h,随机分为胺碘酮组(30例)和毛花甙C组(28例),毛花甙C组静脉注射毛花甙C0.4～0.8mg;胺碘酮组静脉注射胺碘酮150或225mg后改为静脉滴注150～450mg,观察其复律情况,心室率的变化,QT间期及药物副作用。结果毛花甙C组,阵发性房颤24例,复律成功11例,阵发性房扑4例,复律成功2例。胺碘酮组,阵发性房颤25例,复律成功19例,阵发性房扑5例,复律成功3例。两组未复律者心室率均有明显控制,QT间期及副作用差异无显著性意义;毛花甙C组复律平均时间3.5h,胺碘酮组平均复律时间6.5h。结论阵发性房颤及房扑的复律胺碘酮疗效高于毛花甙C,二者心室率的控制及副作用无显著性差别,复律时间毛花甙C短于胺碘酮。     

静脉用胺碘酮和毛花甙C转复阵发性房颤即时疗效对比

目的:比较静脉用胺碘酮和毛花甙C治疗阵发性房颤(PAF)的即时疗效和安全性。方法:84例发作时间在 24～72 h的PAF患者被随机分为胺碘酮组和毛花甙C组(每组42例),分别静脉内给予胺碘酮150～1180 mg和毛花甙C 0．4～0．8 mg。结果:胺碘酮和毛花甙C PAF转复率分别是83．3％和42．9％(P<0．01);未转复者的心室率在胺碘酮组由(128．4±12．3)降至(87．8±11．4)次／min(P<0．01),毛花甙C组由(129．6±13．1)降至(90．3± 11．9)次／min(P<0．01)。两组均无严重副作用发生。结论:静脉用胺碘酮治疗阵发性房颤有效且安全,其转复率显著高于毛花甙C。     

普罗帕酮与洋地黄转复慢性心房颤动的比较

目的 比较普罗帕酮与洋地黄转复慢性房颤的作用。方法 房颤发作时间大于3周的患者随机分为普罗帕酮组和洋地黄组,普罗帕酮组先静脉推注普罗帕酮2mg/kg,再以5mg/kg维持24小时,后改口服每天450mg治疗4周。洋地黄组先静脉推注毛花甙C 0.4mg,然后每6小时静脉推注0．2mg,24小时后改口服地高辛每日0．25mg。结果 普罗帕酮组17例（48．6％）转复为窦性心律,洋地黄组仅2例转复成功。普罗帕酮组转复成功者与未转复者相比,左房内径明显较小（P＜0．001）,房颤持续时间显著较短（P＜0．001）。结论 普罗帕酮可有效地用于慢性房颤的转复,洋地黄转复慢性房颤疗效不佳;左房内径、房颤持续时间是影响转复成功的重要因素。     

Pharmacological cardioversion with intravenous propafenone in atrial fibrillation

The efficacy and safety of intravenous propafenone for conversion of recent-onset and chronic atrial fibrillation was assessed in 46 patients. 40 with atrial fibrillation associated with or without structural heart disease (mean age 63 +/- 14 years) and 6 patients with atrial fibrillation related to the Wolff-Parkinson-White syndrome (mean age 34.8 +/- 13 years). Propafenone treatment was administered at 2 mg/kg over 15 minutes under continuous electrocardiographic monitoring. In 28 of 32 (87.5%) patients with paroxysmal and/or recent-onset atrial fibrillation a stable sinus rhythm was restored within 1 hour after propafenone (mean 17 +/- 11 minutes) and in only 3 of 8 (37.5%) with chronic atrial fibrillation (p < 0.05). Conversion to sinus rhythm was obtained in 5 of 6 (83.3%) patients with atrial fibrillation related ventricular preexcitation, mean time 21 +/- 12 minutes. Propafenone had an additional effect reducing mean heart rate (141 +/- 21 to 102 +/- 15 beat per minute, p < 0.05) and the shortest preexcited R-R intervals was increased, mean 231.6 +/- 27.8 to 355 +/- 37.2 milliseconds (p < 0.001) in cases associated with ventricular preexcitation. Dizziness, hypotension and transient conduction disturbances occurred in only one patient with rheumatic valvular heart disease: EF 40%. Propafenone is an effective and safe antiarrhythmic drug for converting paroxysmal and/or recent-onset atrial fibrillation of various origins with a more limited efficacy in chronic atrial fibrillation.     

Intravenous propafenone in paroxysmal atrial fibrillation: A randomized,placebo-controlled,double-blind,multicenter clinical trial

Background: Pharmacological conversion of paroxysmal atrial fibrillation is frequently necessary. The aim of this study was to compare intravenous propafenone, a class Ic antiar-rhythmic agent, with placebo in paroxysmal atrial fibrillation (AF) of recent onset (<72 h). Patients and methods: We randomly allocated 75 patients, aged 18 to 70 years, with paroxysmal AF to receive intravenous propafenone (2 mg/kg in 15 min followed by 1 mg/kg in 2 h) or the matching placebo. Patients were followed for 3 h. Exclusion criteria were the presence of one of the following: clinical heart failure, recent acute myocardial infarction, hypotension, atrioventricular block, Wolff-Parkinson-White syndrome, or current treatment with antiarrhythmic agents or digitalis. Results: No sign of heart disease was found in 74.7% of the patients. Echocardiographically determined left atrium diameter was similar in the two groups. Conversion to sinus rhythm occurred in 24 of 41 patients allocated to propafenone and in 10 of 34 patients allocated to placebo (odds ratio 3.2, 95% confidence intervals 1.3-7.9;p<0.01). Mean conversion time was 34 ± 29 and 71 ± 55 min, respectively, for propafenone and placebo. Mean heart rate in nonconverters decreased from 146 to 109 beats/min in patients treated with propafenone while it remained virtually unchanged in those treated with placebo. Only minor side effects were noted. Conclusions: Intravenous propafenone is an effective therapeutic option for restoring sinus rhythm in patients with paroxysmal AF of recent onset.     

45例阵发性房颤患者静脉注射胺碘酮转复的临床分析

目的:评估静脉注射胺碘酮转复阵发性房颤的疗效及安全性。方法:45例阵发性房颤(发作时间≤7 d)患者,均患有器质性心脏病,采用胺碘酮负荷量150 mg,稀释后10 min静脉注射,继之以1 mg/min静脉滴注维持;必要时15 min后重复负荷量150 mg;6 h后以0.5 mg/min维持,转复后逐渐过渡到口服胺碘酮长期维持。结果:24 h内45例心室率均有效控制,37例复律成功,转复成功率82%;转复后出现长RR间期2例,窦性心动过缓2例,无动脉血栓栓塞及尖端扭转性室速发生。结论:静脉注射胺碘酮转复有器质性心脏病合并阵发性房颤患者安全有效,转复治疗中积极防治并发症至关重要。     

药物治疗高龄患者阵发性心房颤动的1年随访

目的 观察胺碘酮、普罗帕酮、索他洛尔治疗老年阵发性心房颤动的疗效.方法 82例年龄85岁及以上高龄的阵发性心房颤动患者随机分为胺碘酮组 （39例）、普罗帕酮组 （21例） 和索他洛尔 （22 例） 组,分别选用胺碘酮、普罗帕酮、索他洛尔进行复律治疗.结果 3组患者服药后48h内有效率分别为 96%、35%、17%,组间差异有统计学意义.1年随访有效率分别为 86%、25%、1l%,组间差异有统计学意义.3组药物的不良反应发生率分别为 26%、15%、10%,差异有统计学意义;胺碘酮严重不良反应多见.结论 3种药物中胺碘酮治疗高龄患者阵发性心房颤动的疗效最佳,但不良反应明显,其他两种药物有一定疗效,但不良反应相对较少.     

Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias: Report from the Flecainide and Propafenone Italian Study (FAPIS) group

In order to compare the long-term safety of flecainide and propafenone,an open label, randomized, parallel group study was performedin 335 patients with paroxysmal atrial fibrillation (n=200)or paroxysmal supra ventricular tachycardia (n=135), and nohistory of heart disease. Patients were treated with an initialdaily dose of flecainide 100 mg (n=72) or propafenone 450 mg(n=63) for paroxysmal supraventricular tachycardia and flecainide200 mg (n=97) or propafenone 450 mg (n=103) for paroxysmal atrialfibrillation. Dose escalations were permitted after 2 attacks,up to a maximum of flecainide 300 mg or propafenone 900 mg.day^–1. Follow-up duration was 12 months, or when patientsstopped the treatment as a result of inadequate efficacy oradverse experiences. Twelve patients on flecainide reported 16 cardiac adverse experiences,of whom six discontinued the treatment. Seven propafenone patientshad eight cardiac adverse experiences, of whom five discontinuedthe treatment. Serious proarrhythmic events were infrequent:one case of ventricular tachycardia on propafenone; two casesof atrial fibrillation with rapid ventricular response on flecainide,associated in one patient with pulmonary oedema. An intention-to-treat analysis showed that the probability of12 months' safe and effective treatment of paroxysmal supraventriculartachycardia was 93% for flecainide and 86% for propafenone (P=0·24),whereas in paroxysmal atrial fibrillation it was 77% for flecainideand 75% for propafenone (P=0·72). In conclusion, flecainide and propafenone were safe in the long-termtreatment of patients with paroxysmal supraventricular tachyarrhythmiasand without evidence of clinically significant heart disease.     

A Review of Clinical Trials Assessing the Efficacy and Safety of Newer Antiarrhythmic Drugs in Atrial Fibrillation

Clinical trials assessing the efficacy of anti- arrhythmic drugs for terminating atrial fibrillation have demonstrated that rate control drugs have little to no added efficacy compared to placebo; however, spontaneous conversion of recent-onset atrial fibrillation is common. Antiarrhythmic drugs such as oral dofetilide, oral bolus-flecainide and propafenone and intravenous ibutilide all have a role in terminating atrial fibrillation. Active comparator trials have demonstrated that amiodarone is more efficacious in maintaining sinus rhythm than propafenone and sotalol. Multiple trials have demonstrated the safety of amiodarone, sotalol, dofetilide and azimilide in a post-myocardial infarction population and amiodarone and dofetilide in a congestive heart failure population. Newer antiarrhythmic agents, some with novel mechanisms of action, will add to the pharmacologic armamentarium in treating atrial fibrillation.     

Comparisons of oral propafenone and quinidine as an initial treatment option in patients with symptomatic paroxysmal atrial fibrillation: a double-blind, randomized trial

Objective. The main aim of the study was to evaluate the safety and efficacy of propafenone versus quinidine as an initial choice in treatment of symptomatic paroxysmal atrial fibrillation. Design. The study consisted of a 3-month treatment with oral propafenone hydrochloride or quinidine sulphate in patients with paroxysmal symptomatic atrial fibrillation, according to a double-blind randomized system. Setting. The study was performed in the out-patient clinic of university hospital. Main outcome measures. The effects of the two drugs on attack frequency, ventricular rate and symptoms of symptomatic paroxysmal atrial fibrillation. Results. In the oral propafenone group (n=48), two patients (4%) discontinued the treatment because of dizziness. In the 46 patients who continued the treatment, the attack frequency decreased from 11±3 times per week at baseline to 1±1 times per week after treatment (P<0.01). Forty (87%) out of the 46 patients had effective response to oral propafenone (more than 75% reduction of symptomatic arrhythmic attacks) on a mean dose of 615±10 mg day^-1; the decrease in attack frequency was from 10±3 to 1±1 times per week. Twenty-three (50%) patients were free from recurrence of symptomatic paroxysmal atrial fibrillation. Comparisons of symptom scores for patients (n=23) with attacks of paroxysmal atrial fibrillation after oral propafenone treatment showed that there was a significantly lower symptom score of palpitation, asthenia, effort dyspnea, dizziness, rest dyspnea and chest oppression in attacks of paroxysmal atrial fibrillation after propafenone treatment (11.05±3.78 versus 7.60±3.46, P<0.01). From the oral quinidine group (n=48), two patients (4%) discontinued treatment because of gastrointestinal discomfort. In the 46 patients who continued the treatment, the attack frequency decreased from 11±4 times per week at baseline to 3±2 times per week after treatment (P<0.01). Twenty-one (46%) out of the 46 patients had effective response to oral quinidine on a mean dose of 1067±462 mg day^-1, with a decrease in attack frequency from 12±3 to 1±1 times per week. Only 10 (22%) patients were free from recurrence of paroxysmal atrial fibrillation. Comparisons of symptom scores for patients (n=36) with attacks of paroxysmal atrial fibrillation after quinidine treatment showed that there was no significant decrease of symptom score in attacks of atrial fibrillation (10.65±3.92 versus 10.20±3.80, P=0.57). Furthermore, the percentage decrease of ventricular rate during atrial fibrillation was significantly greater in patients with propafenone (-25±4% versus -8±3%, P<0.01). Conclusions. Oral propafenone appeared to be more effective than quinidine in suppressing attacks and alleviating symptoms of paroxysmal atrial fibrillation.     

Safety of flecainide versus propafenone for the long-term management of symptomatic paroxysmal supraventricular tachyarrhythmias: Report from the Flecainide and Propafenone Italian Study (FAPIS) group

In order to compare the long-term safety of flecainide and propafenone,an open label, randomized, parallel group study was performedin 335 patients with paroxysmal atrial fibrillation (n=200)or paroxysmal supra ventricular tachycardia (n=135), and nohistory of heart disease. Patients were treated with an initialdaily dose of flecainide 100 mg (n=72) or propafenone 450 mg(n=63) for paroxysmal supraventricular tachycardia and flecainide200 mg (n=97) or propafenone 450 mg (n=103) for paroxysmal atrialfibrillation. Dose escalations were permitted after 2 attacks,up to a maximum of flecainide 300 mg or propafenone 900 mg.day^–1. Follow-up duration was 12 months, or when patientsstopped the treatment as a result of inadequate efficacy oradverse experiences. Twelve patients on flecainide reported 16 cardiac adverse experiences,of whom six discontinued the treatment. Seven propafenone patientshad eight cardiac adverse experiences, of whom five discontinuedthe treatment. Serious proarrhythmic events were infrequent:one case of ventricular tachycardia on propafenone; two casesof atrial fibrillation with rapid ventricular response on flecainide,associated in one patient with pulmonary oedema. An intention-to-treat analysis showed that the probability of12 months' safe and effective treatment of paroxysmal supraventriculartachycardia was 93% for flecainide and 86% for propafenone (P=0.24),whereas in paroxysmal atrial fibrillation it was 77% for flecainideand 75% for propafenone (P=0.72). In conclusion, flecainide and propafenone were safe in the long-termtreatment of patients with paroxysmal supraventricular tachyarrhythmiasand without evidence of clinically significant heart disease.     

Efficacy of intravenous and per os propafenone in the ambulatory treatment of recent-onset atrial fibrillation]

Propafenone efficacy in conversion of atrial fibrillation to sinus rhythm has been well documented. In this study we considered propafenone efficacy according to a graduated protocol of administration. Forty-two patients with recent-onset atrial fibrillation, without left ventricular failure, ischemic symptoms and in absence of antiarrhythmical treatment, were treated according to the following protocol: propafenone 1 mg/kg i.v. (5 min) followed, in the non-responder patient group, by a second dose, 0.5 mg/kg i.v. (15 min). Patients with persistent atrial fibrillation received 900 mg/daily of propafenone per os, at home for two days. Thereafter, patients still not restored to sinus rhythm were considered non-responders. Patients who were converted to sinus rhythm received 450 mg daily of the drug (oral administration), at home, as antiarrhythmical prophylaxis, for three months. Thirty-nine patients were converted to sinus rhythm (92.8%), 24 of them after intravenous propafenone (57.2%), and the other 15 (35.6%) after oral administration of the drug. The average heart rate in patients not converted to sinus rhythm with intravenous propafenone was significantly reduced after drug administration, compared to basal values (from 136.4 +/- 18.1 to 107.1 +/- 17.6, p < 0.01), allowing home treatment. No major cardiac effects were observed after infusion, nor after oral administration of propafenone. During a three-month follow-up we observed 3 cases of relapsed atrial fibrillation and 2 discontinued treatments due to minor gastroenteric side effects. In conclusion, propafenone therapy in ambulatory regimen is safe and effective in patients with recent-onset atrial fibrillation. In many patients refractory to IV treatment, further therapeutic success may be achieved following oral propafenone administration.