The comparison of intravenous amiodarone versus propafenone for immediate cardioversion of recent-onset atrial fibrillation

ObjectiveTo compare the efficacy and safet y of intravenous amiodarone versus propafenone for immediate cardioversion of re cent-onset atrial fibrillation.Methods95 consecutive pat ients with atrial fibrillation (onset within 48 h) were randomly assigned to two groups: 48 patients in amiodarone group and 47 patients in propafenone group as control. Patients randomized to amiodarone received 150 mg IV over 10 minutes, followed by infusion at 1mg/minute for 6 hours, then 0.5mg/minute for 18 hours. Patients randomized to propafenone received 70mg IV over 10 minutes, if atrial f ibrillation persists, repeat 70 mg boluses was given 30-60 min after the first l oading,daily maintenance dose of 450mg orally. The primary end point was rate o f cardioversion within 24 hours, the secondary end point was rate of cardioversi on at 8 hours. Mortality and adverse events also were analyzed.Result sPropafenone had a significantly better rate of cardioversion than amiodarone for up to eight hours, but there was no difference between the two gr oups at 24 hours. The adverse events were minimal in both groups, with no deaths reported in both groups.Conclusion Intravenous amiodaro ne is as safe and effective as propafenone at 24 hours in cardioversion of recen t-onset atrial fibrillation.