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When the heart beats normally, synchronized contractions of the atria and ventricles fill the heart with blood and pump the blood to the rest of the body. Under certain circumstances, irregularities occur in the rhythmic contractions, disrupting the function of the heart. These irregularities are collectively referred to as arrhythmias; when they affect the cardiac ventricles, they are known as ventricular arrhythmias. The first therapeutic strategy generally employed in treating arrhythmia is administration of antiarrhythmic medication; a number of these drugs have been characterized and are currently widely prescribed. A new antiarrhythmic drug, propafenone (Rhythmol), was recently approved by the Food and Drug Administration for the treatment of life-threatening arrhythmias. Although the drug has been in long-term clinical trials since 1981, most studies have not employed a large enough patient sample to draw strong conclusions concerning the efficacy of propafenone. To assimilate data from all reports published to date, a literature search was conducted via the online databases Bioquest, Medline, and Ringdoc, for all papers published between 1980 and 1989 pertaining to propafenone, as used for the treatment of ventricular arrhythmia. Twenty-seven such studies were identified, involving a total of 684 patients (average age 57; 80 percent male). Sixty-nine percent of the patients had coronary artery disease; the majority had failed to respond to between two and four other antiarrhythmic drugs prior to treatment with propafenone. The drug was administered intravenously in 23 patients, and as an oral preparation in 661. Ninety-seven patients (25 percent) experienced a dramatic reduction in the severity of arrhythmia; 100 additional patients showed moderate improvement, and 16 patients (4 percent) showed mild improvement, for a combined total efficacy of 61 percent. Noncardiac adverse affects forced discontinuation of medication in 42 patients (6.1 percent). Cardiac adverse affects, ranging from mild cardiac irregularity to sudden death, occurred in about nine percent of the patients. (Consumer Summary produced by Reliance Medical Information, Inc.)