[A case of recent atrial flutter treated with intravenous propafenone]

A recently observed case triggers an examination of Propafenone (P.) treatment of atrial flutter (AF). A review of the literature reveals that the question has not so far been sufficiently investigated. In fact only one paper reporting the inadequacy of P. in the treatment of certain forms of AF and atrial fibrillation caused by vagal hypertonia has apparently been published. The case presented here is of a 59 year old man with left bronchial pneumonia in a static phase and an ECG indicating AF. Treatment with P. in slow-release bolus form (2 mg/kg) converted the AF into sinus rhythm in the space of a few minutes. In the absence of any demonstrable cardiac pathology the condition in thought to have been caused by the patient's precarious metabolic status (hypoxaemia, sepsis).