The outcomes of patients with septic shock treated with propafenone compared to amiodarone for supraventricular arrhythmias are related to end-systolic left atrial volume

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00064173%3A_____%2F24%3A43926680" target="_blank" >RIV/00064173:_____/24:43926680 - isvavai.cz</a>

Alternative codes found

RIV/00216208:11110/24:10477417 RIV/00216208:11120/24:43926680 RIV/00064165:_____/24:10477417

Result on the web

<a href="https://doi.org/10.1093/ehjacc/zuae023" target="_blank" >https://doi.org/10.1093/ehjacc/zuae023</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.1093/ehjacc/zuae023" target="_blank" >10.1093/ehjacc/zuae023</a>

Result language

angličtina

Original language name

The outcomes of patients with septic shock treated with propafenone compared to amiodarone for supraventricular arrhythmias are related to end-systolic left atrial volume

Original language description

Aims A recently published trial has shown no differences in outcomes between patients with new-onset supraventricular arrhythmia (SVA) in septic shock treated with either propafenone or amiodarone. However, these outcome data have not been evaluated in relation to the presence or absence of a dilated left atrium (LA). Methods and results Patients with SVA and a left ventricular ejection fraction &gt;= 35% were randomized to receive intravenous propafenone (70 mg bolus followed by 400-840 mg/24 h) or amiodarone (300 mg bolus followed by 600-1800 mg/24 h). They were divided into groups based on whether their end-systolic left atrial volume (LAVI) was &gt;= 40 mL/m(2). The subgroup outcomes assessed were survival at ICU discharge, 1 month, 3 months, 6 months, and 12 months. Propafenone cardioverted earlier (P = 0.009) and with fewer recurrences (P = 0.001) in the patients without LA enlargement (n = 133). Patients with LAVI &lt; 40 mL/m(2) demonstrated a mortality benefit of propafenone over the follow-up of 1 year [Cox regression, hazard ratio (HR) 0.6 (95% CI 0.4; 0.9), P = 0.014]. Patients with dilated LA (n = 37) achieved rhythm control earlier in amiodarone (P = 0.05) with similar rates of recurrences (P = 0.5) compared to propafenone. The outcomes for patients with LAVI &gt;= 40 mL/m(2) were less favourable with propafenone compared to amiodarone at 1 month [HR 3.6 (95% CI 1.03; 12.5), P = 0.045]; however, it did not reach statistical significance at 1 year [HR 1.9 (95% CI 0.8; 4.4), P = 0.138]. Conclusion Patients with non-dilated LA who achieved rhythm control with propafenone in the setting of septic shock had better short-term and long-term outcomes than those treated with amiodarone, which seemed to be more effective in patients with LAVI &gt;= 40 mL/m(2).

Czech name

—

Czech description

—

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30221 - Critical care medicine and Emergency medicine

Project

<a href="/en/project/NV18-06-00417" target="_blank" >NV18-06-00417: Prospective randomized double-blind study of efficacy and safety of 1c class antiarrhythmic agent (propafenone) for supraventricular arrhythmias in septic shock</a><br>

Continuities

P - Projekt vyzkumu a vyvoje financovany z verejnych zdroju (s odkazem do CEP)

Publication year

2024

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

European Heart Journal: Acute Cardiovascular Care

ISSN

2048-8726

e-ISSN

2048-8734

Volume of the periodical

13

Issue of the periodical within the volume

5

Country of publishing house

GB - UNITED KINGDOM

Number of pages

9

Pages from-to

414-422

UT code for WoS article

001185002600001

EID of the result in the Scopus database

2-s2.0-85192942044