[Efficacy of cibenzoline in the termination and long-term prevention of paroxysmal atrial fibrillation: analysis based on the time of onset].

OBJECTIVES

The efficacy of cibenzoline was assessed in the termination and long-term prevention of paroxysmal atrial fibrillation in relation to the time of onset in a series of patients with paroxysmal atrial fibrillation.

METHODS

Study of the termination included 92 patients (63 males, 29 females, mean age 64 +/- 12 years) and study of long-term prevention included 106 patients (77 males, 29 females, mean age 64 +/- 11 years; mean follow-up 32.7 +/- 18.8 months). Paroxysmal atrial fibrillation was classified into 3 types based on the time of onset: day type (AM 7:00-PM 5:00), night type (PM 5:00-AM 7:00) and mixed type (anytime). Successful termination was defined as pharmacological cardioversion within 30 min of the intravenous administration of 70 mg cibenzoline and efficacy of long-term prevention was presented as the event-free ratio of patients after oral administration of 300 mg/day cibenzoline.

RESULTS

Successful pharmacological termination was achieved in 66.7% of the day type (n = 24), 70.0% of the night type (n = 48), and 41.6% of the mixed type (n = 20). There was a significantly higher success in the day type (p < 0.05), and tendency to success in the night type (p = 0.079) compared to the mixed type. The event-free ratios at 1, 3, 6, 12, 24 months after oral administration were 84.6%, 76.9%, 73.1%, 65.4%, 61.5% in the day type (n = 26), 92.0%, 80.0%, 80.0%, 72.0%, 60.0% in the night type (n = 25), and 81.8%, 61.8%, 47.3%, 30.9%, 23.6% in the mixed type (n = 55), respectively. Significantly higher success was achieved at 24 months in the day type and the night type compared to the mixed type (p < 0.05).

CONCLUSIONS

Termination and long-term prevention of paroxysmal atrial fibrillation by cibenzoline has a high degree of efficacy in patients with both day and night onset of paroxysmal atrial fibrillation.