Randomized double-blind study comparing the efficacy and safety between antazoline and propafenone for conversion of paroxysmal atrial fibrillation to sinus rhythm (AnProAF study).

Antazoline is an antiarhithmic drug (ADD); however, no randomized clinical trial (RCT) evaluated its efficacy and safety for cardioversion of recent-onset atrial fibrillation (AF) compared with other approved ADD drugs Objectives: This study aimed to compare clinical efficacy and safety of antazoline with those of propafenone in the rapid conversion of paroxysmal non-valvular AF to sinus rhythm in patients without heart failure. This was a single-center, randomized, double-blind study. A total of 94 patients with AF (lasting <48 hours) in stable cardiopulmonary condition and eligible for cardioversion were enrolled. Patients who fulfilled the selection criteria were randomly assigned to receive either antazoline (up to 300 mg) or propafenone (up to 140 mg) intravenously. The primary endpoint was the conversion of AF to sinus rhythm confirmed on electrocardiography. Overall, 94 participants: 46 (48.9%) in the antazoline group and 48 (51.1%) in the propafenone group were included. The mean age was 67.5 (14) years and 40 (42.5%) were men. The AF was successfully converted in 29 (63%) in antazoline arm and 25 (52.1%) in propafenone arm (P=0.387). Median duration to conversion was 10 minutes in antazoline and 30 minutes in the propafenone group (P=0.029). Severe adverse effects were observed among 5 (10.8%) patients treated with antazoline and 5 (10.4%) with propafenone. Intravenous antazoline demonstrated efficacy and safety comparable to those of intravenous propafenone for acute conversion of non-valvular paroxysmal AF to sinus rhythm in patients without heart failure.