Efficacy and safety of antazoline in the rapid cardioversion of paroxysmal atrial fibrillation (the AnPAF Study).

Abstract

AIMS:

The aim of the study was to assess the clinical efficacy of antazoline, a first-generation anti-histaminic agent, in the rapid conversion of paroxysmal non-valvular atrial fibrillation (AF) to sinus rhythm in patients without heart failure.

METHODS AND RESULTS:

This study was a single center, randomized, double blind, placebo-controlled, superiority clinical trial. We enrolled patients with an AF episode lasting less than 43 h, in stable cardiopulmonary condition. Subjects who fulfilled the selection criteria were randomly assigned to receive intravenously either a placebo or up to 250 mg of antazoline. The primary end point was the conversion of AF to sinus rhythm confirmed in electrocardiogram (ECG). We enrolled 74 patients: 36 (48.6%) in the antazoline group and 38 (51.4%) in the control group. The mean age was 68 ± 12 years (range 31-90 years), 39 (53.3%) patients were male. The successful conversion of AF to sinus rhythm during the observation period was achieved in 26 (72.2%) patients treated with antazoline and 4 (10.5%) in the control group: RR 6.86 (95% CI: 2.66-17.72, P < 0.0001). Median time to conversion was 16.0 min in antazoline and 72.5 min in the control group (P = 0.0246). There were no cases of atrial tachycardia/flutter in the antazoline group.

CONCLUSION:

Intravenous antazoline was effective and safe in the rapid conversion of non-valvular paroxysmal atrial fibrillation to sinus rhythm in patients without heart failure. Clinical Trial Registration number: NCT01527279.

• Authors: Aleksander Maciag, Michal M Farkowski, Tomasz Chwyczko, Maciej Beckowski, Pawel Syska, Ilona Kowalik, Mariusz Pytkowski, Jacek Wozniak, Rafal Dabrowski, Hanna Szwed
• Journal: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology (Europace) Vol. 19 Issue 10 Pg. 1637-1642 (Oct 01 2017) ISSN: 1532-2092 [Electronic] England
• PMID: 28339554 (Publication Type: Journal Article, Randomized Controlled Trial)
• Copyright: Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2016. For Permissions, please email: [email protected].

Chemical References

• Anti-Arrhythmia Agents
• Histamine H1 Antagonists
• Antazoline

Topics

• Action Potentials (drug effects)
• Administration, Intravenous
• Adult
• Aged
• Aged, 80 and over
• Antazoline (administration & dosage, adverse effects)
• Anti-Arrhythmia Agents (administration & dosage, adverse effects)
• Atrial Fibrillation (diagnosis, drug therapy, physiopathology)
• Double-Blind Method
• Electrocardiography
• Female
• Heart Conduction System (drug effects, physiopathology)
• Heart Rate (drug effects)
• Histamine H1 Antagonists (administration & dosage, adverse effects)
• Humans
• Male
• Middle Aged
• Poland
• Time Factors
• Treatment Outcome