Effect of cibenzoline on atrial vulnerability and value of electrophysiological methods in the treatment of paroxysmal atrial fibrillation

The effects of intravenous cibenzoline (1,5 mg/kg) on atrial vulnerability and electrophysiology were assessed in 25 patients with documented paroxysmal atrial fibrillation, in whom sustained (greater than 30 s) atrial fibrillation/-flutter was induced by programmed atrial stimulation. In seven patients atrial fibrillation persisted despite the application of cibenzoline; in eight patients induction of atrial fibrillation was not prevented. In 10 patients the induction of sustained atrial fibrillation was prevented by cibenzoline. Intraatrial conduction time and shortest ventricular cycle length during atrial fibrillation were increased by cibenzoline (p less than or equal to 0.01). The effective refractory period of the right atrium was not significantly affected. Eight patients with frequent episodes of paroxysmal atrial fibrillation received oral cibenzoline (320 mg/day) for control of paroxysmal atrial fibrillation irrespective of the efficacy of intravenous cibenzoline. Prevention of stimulation-induced atrial fibrillation predicted successful treatment of paroxysmal AF. In conclusion, cibenzoline might be effective in the treatment of atrial tachyarrhythmias. Programmed atrial stimulation seems to be helpful in the prediction of the efficacy of an antiarrhythmic treatment of paroxysmal atrial fibrillation.