Oral loading of propafenone: restoring its role before restoring rhythm—authors’ reply

We wish to thank Martignani et al. 1 for their critical Letterto the Editoraccording to our article recently published in Europace 2 where they question our proposal that propafenoneshould not be generally excluded from cardioversionof paroxysmal atrial fibrillationin patients with structural heart disease. Recent 2016 European Society of Cardiology Guidelines for the Managementof Atrial Fibrillation3 support the use of propafenonefor acute pharmacological cardioversionin patients with new onset of atrial fibrillation. However, their restriction that propafenoneshould only be given to patients without structural heart disease3 particularly bases on CAST (the Cardiac Arrhythmias Suppression Trial), …