Propafenone in the prevention of non-ventricular arrhythmias associated with the Wolff-Parkinson-White syndrome
Abstract
The antiarrhythmic effect of oral propafenone was evaluated in 10 patients with Wolff-Parkinson-White syndrome presenting with non-ventricular arrhythmias (paroxysmal supraventricular tachycardia n = 7, atrial fibrillation or flutter n = 3). The mean age was 38 +/- 13 years, the dose varied from 300 to 900 mg three times a day (mean 450 +/- 188) and the mean follow-up period was 7 +/- 3.5 months. All patients' drug responses were assessed on 12-lead electrocardiograms and 24-hour ambulatory Holter monitoring. Electrophysiologic studies were performed in cases of sustained tachycardia while echocardiography identified 2 cases with mitral valve prolapse. Four of 10 (40%) patients became asymptomatic on a starting propafenone dose of 300 mg, while 6 (60%) had recurrences necessitating an increase in dose for the complete control of the symptoms. We observed a slight slowing of the heart rate and an increase of the mean Q-T interval (P less than 0.001). Three patients reported minor side effects including nausea, dizziness and constipation that were tolerable and dosage dependent. It is concluded that propafenone is an effective and well tolerated drug for the treatment of non-ventricular arrhythmias associated with the Wolff-Parkinson-White syndrome.
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Small trials have reported safety and efficacy of Class Ic antiarrhythmic drugs with beta blockers in WPW syndrome, but no randomized trials in this setting have been performed.
“Small trials have reported the safety and efficacy of this drug therapy in the context of WPW syndrome, 323,324 but no randomized trials in this setting have been performed.”
From European Heart Rhythm Association (EHRA) consensus document on the management of supraventricular arrhythmias, endorsed by Heart Rhythm Society (HRS), Asia-Pacific Heart Rhythm Society (APHRS), and Sociedad Latinoamericana de Estimulacion Cardiaca y Electrofisiologia (SOLAECE) (2017) · cites this paper as [324]
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- Authors
- Vassiliadis, I., Papoutsakis, P., Kallikazaros, I., & Stefanadis, C.
- Affiliations
- Athens Naval & Veterans Hospital (GR)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1990-04
- Volume
- 27
- Issue
- 1
- Pages
- 63-70
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2069229743
- Cited by
- 18
- References
- 20
- Citations by year
- 2026: 1 · 2025: 1 · 2021: 1 · 2019: 1 · 2016: 2 · 2013: 1
- FWCI
- 0.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Keywords
- propafenone, Wolff-Parkinson-White syndrome, paroxysmal supraventricular tachycardia, atrial fibrillation, atrial flutter, antiarrhythmic therapy, drug tolerability, QT interval, heart rate reduction
- MeSH terms
- Adult, Atrial Fibrillation, Drug Administration Schedule, Echocardiography, Electrocardiography, Female, Follow-Up Studies, Heart Rate, Humans, Male, Middle Aged, Propafenone, Recurrence, Tachycardia, Supraventricular, Wolff-Parkinson-White Syndrome, Electrocardiography, Ambulatory
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