RT-53
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Efficacy of a single dose of
oral propafenone on atrial fibrillation prophylaxis in hemodialysis patients
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Flavio Doni, Margherita Manfredi,
Carlo Piemonti, Elio Staffiere, Andrea Rimondini, Cesare Fiorentini*.
Department of Cardiology, Policlinico San Pietro, Ponte San Pietro, *University
of Milan, Italy
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Abstract
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Paroxysmal atrial fibrillation (PAF) is a common
clinical problem in hemodialysis (H) patients. The arrhythmia, usually observed during H,
has commonly a spontaneous resolution within few hours but frequently gives hemodynamic
problems.
We studied the possible beneficial effect of propafenone (P) on PAF prophylaxis in H
patients.
Of 168 patients from two centers of H, 23 were selected on the basis of at least two
episodes of PAF documented in a 1-year period of observation. The total number of PAF was
51: 48 (94%) occurred during H.
The mean ventricular rate was 123 ± 11 beats/minute (BM). In all the episodes a
spontaneous resumption of sinus rhythm was observed after a mean duration of 153 ± 54
minutes.
All patients were given P 450 mg daily and a follow-up of 12 months was carried out.
A significant decrease of PAF episodes was documented: 11 vs 51 (p < 0.001), with a
significant shortening of their duration: 105 ± 43 vs 153 ± 54 minutes (p < 0.05). A
significant reduction of mean ventricular rate was assessed: 108 ± 12 vs 123 ± 11 BM (p
< 0.05). All episodes occurred during H procedure.
Considering the particular distribution of PAF episodes, we have decided to program
another year of follow-up, giving a single dose of 300 mg of P, one hour before the
procedure.
No significant differences had been documented for what concerns numbers of PAF
episodes (11 vs 12), their duration (105 ± 43 vs 111 ± 38), their mean ventricular rate
(108 ± 12 vs 106 ± 15). Only two episodes of PAF were documented during the
interdialytic period.
Our study shows that P is highly effective and safe in reducing PAF episodes in H
patients.
The administration of a single dose of P before H, has the same efficacy as the
chronic treatment.
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Key Words
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Atrial fibrillation
propafenone, prophylaxis of atrial fibrillation, hemodialysis patients, OA
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