Drug conversion of heart rhythm by procainamide and niferidil in patients with atrial fibrillation and flutter

The prevalence and recurrent course of fibrillation and atrial flutter, as well as complications developing with these cardiac arrhythmias, make the problem of finding drugs for effective and safe finish of paroxysms urgent. Aims: to compare the efficacy and safety of drug conversion of rhythm with procainamide and niferidil in patients with atrial fibrillation and flutter. Materials and methods: the study included 102 patients with cardiac arrhythmias of the type of atrial fibrillation or flutter. 50 patients attempted drug conversion of the rhythm with niferidil, 52 with procainamide. The frequency of sinus rhythm recovery was estimated, the reasons for the lack of effect were analyzed, and the prevalence of complications for each of the compared drugs was analyzed. Results: it was established that in drug-induced conversion of the heart rhythm with niferidil or procainamide, the frequency of sinus rhythm recovery in patients with atrial fibrillation was almost the same, and in patients with atrial flutter, paroxysm suppression occurred much more often when using niferidil. In patients receiving niferidil, bradycardia with a heart rate of less than 60 beats per minute, frequent ventricular extrasystolia, as well as an increase in the QTc interval on ECG were more often recorded, and when procainamide is used, the lengthening of the PQ and QRS intervals is more pronounced. Conclusions: for the relief of atrial flutter, niferedil is more effective than procainamide. But its use requires caution due to the likelihood of developing proarrhythmogenic effects.