Abstract 136: Changes of Myocardial Contractility in Hypertensive Patients With Persistent Atrial Fibrillation Receiving Propafenone
Objective: To study the effect of propafenone 450 mg daily on myocardial contractility in hypertensive patients with persistent atrial fibrillation (AF).
METHODS: Study included 32 hypertensive patients with persistent AF, aged from 39 to 63 years (median age 58,6±5,3 years), 14 of them (44%) were men and 18 (56%) were women. Sinus rhythm was restored within 24 hours after the oral loading dose of propafenone 600 mg in all the patients. All the patients received propafenone 450 mg daily to prevent AF paroxysms during the next 12 months. Planar equilibrium radionuclide ventriculography was performed in all the patients to assess myocardial function. Initial study was performed in 32 (100%) patients within the first 3 days after sinus rhythm restoration, the follow-up imaging study was carried out in 18 (56%) patients with sustained sinus rhythm after 12 months.
Results: After 12 months of treatment with propafenone, 18 (56%) of hypertensive patients remained in sinus rhythm. Recurrent episodes of AF were registered in 14 (44%) patients during 12 month follow-up period, hence they were excluded from the study. Initial radionuclide ventriculography made after sinus rhythm restoration in hypertensive patients with persistent AF demonstrated myocardial diastolic dysfunction manifested as significant decrease of time to 30% filling and peak LV and RV filling rate. Follow-up study after propafenone treatment during 12 months revealed significant increase in time to 30% filling and peak LV and RV filling rate. Normal values of atrial contribution to left and right ventricular filling were observed in patients maintaining sinus rhythm during 12 month treatment period with propafenone (p<0.05). Systolic parameters and volume of both ventricles remained normal and showed no significant changes. Left and right ventricular ejection fraction before the treatment start and after propafenone administration during 12 months remained within the normal range.
Conclusion: Propafenone 450 mg daily administered for recurrent AF prevention does not affect left and right ventricular contractility. Sinus rhythm maintenance for 12 months in hypertensive patients with persistent AF restores atrial contractility and improves ventricular diastolic function.
- © 2012 by American Heart Association, Inc.