section name header

Evidence summaries

Propafenone for Maintaining Sinus Rhythm after Cardioversion of Atrial Fibrillation

Propafenone is more effective than placebo in reducing atrial fibrillation recurrence after cardioversion. Level of evidence: "A"

Summary

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.

Clinical comments

Note

Date of latest search:

    References

    • Valembois L, Audureau E, Takeda A et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev 2019;(9):CD005049. [PubMed]

Primary/Secondary Keywords