A Cochrane review on antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation [Abstract] 1 included 59 studies with a total of 20 981 subjects. Propafenone was included in 13 of the studies with a total of 2 258 subjects, and 5 of them compared propafenone with placebo.
Compared to placebo propafenone reduced atrial fibrillation recurrence (RR 0.67, 95% CI 0.61 to 0.74; 5 studies, n=1 098). Recurrence rate was 73% in the control group and 49% (45% to 54%) in the propafenone group; NNTB was 4 (95% CI 3 to 5) participants treated for 1 year to avoid one recurrence.
There was no significant difference in proarrhythmia (RR 1.32, 95% CI 0.39 to 4.47; 3 studies, n=381) or all-cause mortality between propafenone and placebo (RR 0.19, 95% CI 0.02 to 1.68; 2 studies, n=212). Propafenone increased withdrawals due to adverse effects (RR 1.62, 95% CI 1.07 to 2.46; 5 studies, n=1 098) compared with placebo; NNTH for propafenone was 26 (95% CI 11 to 234) participants treated for 1 year to have one additional withdrawal.
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