Mattioli A V, Lucchi G R, Vivoli D, Mattioli G
Department of Cardiology, Internal Medicine, University of Modena, Italy.
Clin Cardiol. 1998 Oct;21(10):763-6. doi: 10.1002/clc.4960211013.
Antiarrhythmic drugs are widely used for treatment of atrial fibrillation (AF) and restoration of sinus rhythm. This prospective, randomized, and controlled study compared the efficiency and safety of propafenone versus procainamide for the treatment of acute AF.
In all, 117 patients (55 women, 62 men, mean age 64.2 +/- 13 years, median 63 years) who presented with AF were included in the study. Exclusion criteria were signs or symptoms of heart failure on physical examination, recent myocardial infarction or cardiac surgery, cardiogenic shock, or hypotension. Forty-one patients spontaneously recovered sinus rhythm; the remaining 76 patients were randomized to receive propafenone or procainamide. Propafenone was given at a dose of 2 mg/kg body weight intravenously (i.v.) over 30 min. Patients randomized to receive procainamide received a bolus of 100 mg i.v. administered every 5 min up to a maximum dose of 1 g. The clinical characteristics of the two groups were comparable.
The number of patients who recovered sinus rhythm after the treatment was larger in the procainamide-treated group (Group 1) (69.5%) than in the propafenone-treated group (Group 2) (48.7%); p < 0.05. The time required for cardioversion was significantly lower in Group 1 (mean 4.1 +/- 1.3 h), than in Group 2 patients (mean 7.3 +/- 2.6 h) (p < 0.01).
In the present study, procainamide was more effective than propafenone for the treatment of AF of short duration.
抗心律失常药物广泛应用于心房颤动（AF）的治疗及窦性心律的恢复。本前瞻性、随机对照研究比较了普罗帕酮与普鲁卡因胺治疗急性AF的有效性和安全性。
共有117例出现AF的患者（55例女性，62例男性，平均年龄64.2±13岁，中位数63岁）纳入本研究。排除标准为体格检查有心力衰竭的体征或症状、近期心肌梗死或心脏手术史、心源性休克或低血压。41例患者自发恢复窦性心律；其余76例患者随机接受普罗帕酮或普鲁卡因胺治疗。普罗帕酮以2mg/kg体重的剂量在30分钟内静脉注射。随机接受普鲁卡因胺治疗的患者每5分钟静脉推注100mg，最大剂量为1g。两组的临床特征具有可比性。
普鲁卡因胺治疗组（第1组）治疗后恢复窦性心律的患者数量（69.5%）多于普罗帕酮治疗组（第2组）（48.7%）；p<0.05。第1组患者转复所需时间（平均4.1±1.3小时）显著低于第2组患者（平均7.3±2.6小时）（p<0.01）。
在本研究中，普鲁卡因胺治疗短期AF比普罗帕酮更有效。
