The authors studied the efficacy of intravenous (IV) (1.5-2 mg/kg) and oral propafenone (450 to 900 mg/day) in 16 patients with paroxysmal, sus tained, recurrent supraventricular tachycardia (SVT). In 5 patients IV propafenone was not given, because of intolerant SVT. Nine patients had Wolff-Parkinson-White syndrome.
IV propafenone immediately stopped and prevented reinduction of SVT in 9/11 patients. Oral propa fenone prevented SVT induction in 3 of 5 patients. In the 9 patients re sponsive to IV propafenone, oral pro pafenone was effective: in particular, in 6 patients SVT tachycardia was not induced by serial transesophageal pacings, and in the remaining 3 pa tients the arrhythmia was still in duced but was slower and of brief duration (3-5 seconds). In 11/12 pa tients responsive to oral propafenone the minimum effective dosage in pre venting the induction of the arrhyth mia was 600 mg/day. In only 1 patient was the dose of 450 mg/day equally effective.
Propafenone administration was not associated with major side ef fects. In conclusion, propafenone is very effective in the control of parox ysmal supraventricular tachycardia; intravenous propafenone can predict the efficacy of oral therapy.
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References
1.
Dukes ID, Vaughan Williams EM: The multiple modes of action of propafenone. Eur Heart J5:115-125, 1984.
2.
McLeon AA, Stiles GL, Shand DG: Demonstration of beta adrenoceptor blockade by propafenone hydrochloride: Clinical, pharmacologic, radiologic and binding and adenylate cyclase activation studies. J Pharmacol Exp Ther228:461-464, 1984.
3.
Ludmer PL, McGowan NE, Antman EM, et al: Efficacy of propafenone in Wolff-Parkinson-White Syndrome: Electrophysiologic findings and long-term follow-up. J Am Coll Cardiol9:1357-1363, 1987.
4.
Hammill SC, McLaran CJ, Wood DL, et al: Double-blind study of intravenous propafenone for paroxysmal supraventricular reentrant tachycardia. J Am Coll Cardiol9:1364-1368, 1987.
5.
Breithardt G. , Borggrefe M., Wiebringhaus E., et al: Effect of propafenone in the Wolff-Parkinson-White Syndrome: Electrophysiologic findings and long-term follow-up. Am J Cardiol54:29D-39D, 1984.
6.
Santinelli V. , De Paola M, Turco P., et al: Wolff-Parkinson-White at risk and propafenone: Electrophysiologic findings and long-term follow-up . J Am Coll Cardiol, 5:1138, 1988.
7.
Krikler D., Rowland E.: Management of supraventricular tachycardia with drugs and artificial pacing . In: Cardiac Arrhythmias: Electrophysiology, Diagnosis and Management, ed. by Narula OS.Baltimore: Williams & Wilkins, 1979.
8.
Levy S.: Role of pacing in treatment of supraventricular tachycardia. In: Tachycardias: Mechanisms, Diagnosis, Treatment, ed. by Josephson ME, Wellens HJJ.Philadelphia: Lea & Febiger, 1984.
