The effect of dronedarone and propafenone in preventing postoperative recurrence in patients with atrial fibrillation and its influence on inflammatory response and myocardial injury
10.3969/j.issn.1008-794X.2025.12.011
- VernacularTitle:决奈达隆或普罗帕酮预防心房颤动患者环肺静脉电隔离术后复发效果及其对炎症反应和心肌损伤影响
- Author:
Feng LI
1
;
Jun WU
;
Shiyi LONG
;
Fang WANG
;
Songhai WEN
Author Information
1. 556000 贵州凯里 贵州省黔东南苗族侗族自治州人民医院心血管内科
- Keywords:
inflammatory response;
propafenone;
myocardial injury;
dronedarone;
recurrence of atrial fibrillation
- From:
Journal of Interventional Radiology
2025;34(12):1343-1348
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analyze the effect of dronedarone and propafenone in preventing postoperative recurrence in patients with atrial fibrillation(AF)and to discuss its influence on inflammatory response and myocardial injury.Methods A total of 113 patients with AF,who were admitted to the Qiandongnan People's Hospital of China from July 2022 to March 2024,were enrolled in this study.By using random number table method,the patients were divided into control group(n=56)and study group(n=57).All patients received circumpulmonary vein electrical isolation.After treatment,the patients of control group were given propafenone orally for three months,while the patients of study group received dronedarone orally for three months.Both the preoperative and postoperative 3-month inflammatory response indicators including hypersensitive C-reactive protein(Hs-CRP),leucolipin,nucleotide-bound oligomeric domain-like receptor protein 3(NLRP3)inflammasome,and tumor necrosis factor α(TNF-α),the echocardiographic indicators including left atrial maximum volume(LAMV),left ventricular end-systolic diameter(LVESD),and left ventricular ejection fraction(LVEF),the myocardial injury markers including creatine kinase(CK),cardiac troponin I(cTn I),the central nervous specific protein β(S100β),the creatine kinase isoenzyme(CK-MB),the adverse reactions,and the recurrence of AF were compared between the two groups.Results At 3 months after treatment,the serum levels of hs-CRP,leucolipin,NLRP3 inflammasome and TNF-α were decreased in both groups(all P＜0.01),which in the study group were obviously lower than those in the control group(all P＜0.001);the levels of LAMV and LVESD were decreased in both groups(both P＜0.01),which in the study group were remarkably lower than those in the control group(both P＜0.001);the level of LVEF was increased in both groups(P＜0.01),which in the study group was significantly higher than that in the control group(P＜0.001);the levels of CK,cTn I,S100β,and CK-MB were decreased in both groups(all P＜0.01),which in the study group were strikingly lower than those in the control group(all P＜0.001).The incidence of adverse drug reactions in control group and in the study group was 5.36％(3/56)and 7.02％(4/57 cases)respectively,and the difference was not statistically significant(P＞0.05).Within 3 months after treatment,the recurrence rate in the study group was 5.26％(3/57),which was lower than 19.64％(11/56)in the control group,and the difference was statistically significant(P＜0.05).Conclusion Compared with propafenone,the use of dronedarone after circumferential pulmonary vein electrical isolation in patients with AF can improve the cardiac functions,reduce myocardial injury and inflammatory responses,and lower the risk of postoperative recurrence of AF.
