Arrhythmias: Propafenone shows class Ic and class II antiarrhythmic effects


Propafenone ( Rytmonorm; Rythmol ) is a class Ic antiarrhythmic agent. It has the typical chemical structure of a beta-blocker, but human studies on its beta-blocking effects revealed conflicting results.

Twelve healthy males received single oral doses of 600 mg Propafenone and placebo according to a randomized, double-blind, placebo-controlled, cross-over protocol.
Four hours following drug intake, heart rate and blood pressure were measured, and plasma concentrations of Propafenone were determined at rest, during exercise and after recovery.

At exercise, Propafenone significantly decreased heart rate ( -6%, P less than 0.05 ), systolic blood pressure ( -6%, P less than 0.05 ), and the rate-pressure product ( -11%, P less than 0.05 ).

Plasma concentrations of Propafenone increased during exercise ( +23%, P less than 0.05 ) and decreased during recovery ( -33%, P less than 0.05 ).

In conclusion, both effects on heart rate and blood pressure as well as the changes of plasma concentrations of Propafenone during exercise represent two particular features of beta-blockers.
Therefore, researchers have concluded that Propafenone is both a class Ic and a class II antiarrhythmic agent, and 600 mg Propafenone, i.e. the dose recommended in current guidelines for cardioversion of paroxysmal atrial fibrillation, cause clinically significant beta-blockade.
Thus, single oral doses of 600 mg Propafenone appear also suitable for cardioversion of paroxysmal atrial fibrillation in patients with structural heart disease since beta-blockers are explicitly indicated in the treatment of both coronary artery disease and heart failure. ( Xagena )

Stoschitzky K et al, Europace 2016;18: 568-571

XagenaMedicine_2016



Indietro

Altri articoli

COVID-19 can have fatal consequences for people with underlying cardiovascular disease and cause cardiac injury even in patients without underlying...


Atrial fibrillation is the most frequent sustained arrhythmia. Atrial fibrillation often recurs after restoration of normal sinus rhythm. Antiarrhythmic drugs...


Implantable cardioverter-defibrillator ( ICD ) use is associated with reduced short- and long-term mortality in patients with heart failure. Patients with...


The FDA ( U.S. Food and Drug Administration ) has granted accelerated approval to Brukinsa ( Zanubrutinib ) capsules for...


The European Commission has approved a label update for the use of once-daily Relvar Ellipta ( Fluticasone furoate / Vilanterol,...


In acute coronary syndrome ( ACS ), potassium imbalance at admission has been associated with in-hospital arrhythmias, cardiac arrest, and...


Anthracycline-induced cardiotoxicity was first reported in early 1970s. Since then, there has been increasing recognition of its association with poor...


As the Zika virus continues to spread globally, new evidence has emerged about the virus's potentially detrimental effects on the...


Sarcoidosis is an important diagnostic consideration in patients with ventricular tachycardia of unknown origin. The clinical course of ventricular tachycardia...


Ondansetron ( Zofran ) is commonly used to treat vomiting in gastroenteritis, but has a United States FDA ( Food...