Propafenone versus amiodarone for supraventricular arrhythmias in septic shock: a randomised controlled trial
In a double-blind, two-centre trial involving 209 septic shock patients with new-onset arrhythmias, propafenone and amiodarone were compared for efficacy. Although 72.8% of patients on propafenone returned to sinus rhythm within 24 hours compared to 67.3% on amiodarone, the former achieved this in a median time of 3.7 hours, quicker than the 7.3 hours with amiodarone. Notably, propafenone-treated patients experienced fewer arrhythmia recurrences (52%) than those on amiodarone (76%). For those with a dilated left atrium, amiodarone showed superior rhythm control. In conclusion, while propafenone led to faster cardioversion and fewer recurrences, especially in patients with a non-dilated left atrium, both drugs demonstrated similar short- and long-term outcomes.