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Efficacy and safety of propafenone sustained release in the prophylaxis of symptomatic paroxysmal atrial fibrillation (The European Rythmol/Rytmonorm Atrial Fibrillation Trial [ERAFT] Study).

Abstract
We report a double-blind, multicenter, multinational, placebo-controlled, and well-controlled trial to prove that the sustained-release (SR) formulation of propafenone is superior to placebo in preventing symptoms of paroxysmal atrial fibrillation (AF). A total of 594 patients were enrolled in the qualifying period of the study and 293 patients were randomized at 53 centers. There were significant increases in the arrhythmia-free periods from day 5 of randomization to the first recurrence of symptomatic atrial arrhythmia in the propafenone SR 325 mg twice daily (p = 0.004) and propafenone SR 425 mg twice daily (p = 0.003) treatment groups compared with placebo. The median arrhythmia-free time was 9 days in the placebo group, 35 days in the propafenone SR 325 mg twice daily group, and 44 days in the propafenone SR 425 mg twice daily group. There was a significant reduction in average heart rate during the first recurrence of symptomatic arrhythmia after day 5 in the low-dose propafenone group compared with placebo. The median treatment failure time from day 5 (arrhythmia recurrence, adverse events, and withdrawals) was prolonged from 8 days in the placebo group to 19 days in the propafenone SR 325 mg twice daily group (p = 0.002) and to 24 days in the propafenone SR 425 mg twice daily group (p = 0.006). The percentage of patients with >/=1 serious adverse event was similar in the propafenone SR treatment groups (propafenone SR 325 mg twice daily, 10.0%; propafenone SR 425 mg twice daily, 11.2%) but lower in the placebo group (1.1%). In conclusion, the SR formulation of propafenone is superior to placebo, well-tolerated, and prevents symptoms of paroxysmal AF.
AuthorsThomas Meinertz, Gregory Y H Lip, Fedrico Lombardi, Zigmunt P Sadowski, Brigitte Kalsch, Anne Camez, Ann Hewkin, Siegfried Eberle, ERAFT Investigators
JournalThe American journal of cardiology (Am J Cardiol) Vol. 90 Issue 12 Pg. 1300-6 (Dec 15 2002) ISSN: 0002-9149 [Print] United States
PMID12480038 (Publication Type: Clinical Trial, Comparative Study, Evaluation Study, Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Arrhythmia Agents
  • Delayed-Action Preparations
  • Propafenone
Topics
  • Acute Disease
  • Anti-Arrhythmia Agents (therapeutic use)
  • Atrial Fibrillation (drug therapy, prevention & control)
  • Delayed-Action Preparations
  • Double-Blind Method
  • Endpoint Determination
  • Female
  • Heart Rate (drug effects)
  • Humans
  • Male
  • Middle Aged
  • Propafenone (therapeutic use)
  • Proportional Hazards Models
  • Recurrence
  • Safety
  • Treatment Outcome

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