Pharmacological cardioversion (PCV) is commonly a primary option for termination of recent-onset atrial fibrillation (AF) in emergency departments (ED). This is a subanalysis of the CANT II study, evaluating the effectiveness and safety of antazoline in patients (n = 777) at three stages of chronic kidney disease (CKD): Group I > 60 mL/min (n = 531), Group II 45–59 mL/min (n = 149), and Group III < 45 mL/min (n = 97). Patients in Group III were older and with a higher prevalence of co-morbidities; however, we did not find statistically significant differences in the overall effectiveness of PCV in comparison with the other groups. In patients receiving amiodarone, the PCV success rate was similar in all the studied groups, but along with a renal function decline, it decreased in patients receiving antazoline (79.1 vs. 35%; p < 0.001), and it increased almost significantly in patients receiving propafenone (69.9 vs. 100%; p = 0.067). In patients in Group I, antazoline restored a sinus rhythm as effectively as propafenone and amiodarone; however, in patients in Group III, both antazoline and amiodarone became less effective in restoring a sinus rhythm than propafenone (p = 0.002 and p = 0.034, respectively). The rate of safety endpoint was the highest in patients in Group III (eGFR < 45 mL/min), and it was significantly higher than in patients in Groups I and II (p = 0.008 and p = 0.036, respectively). We did not observe antazoline-related adverse events in any of the studied groups of patients. This real-world registry analysis revealed a different influence of CKD on the effectiveness of individual drugs, and while propafenone and amiodarone maintained their AF termination efficacy, antazoline became significantly less effective in restoring sinus rhythm.

Obesity is a global epidemiological problem that significantly contributes to the development of cardiovascular diseases. It is a proven factor for an increased risk of overall mortality and the occurrence of sudden cardiac death (SCD). The disease is accompanied by a structural and functional myocardium remodeling, which often results in ventricular repolarization abnormalities and contributes to the triggering of life-threatening arrhythmias. This heightened state of readiness for proarrhythmia is the cause of the sudden cardiac deaths which are recorded in this group of patients and which often constitute the first manifestation of ongoing cardiac pathology. One of the reasons for these arrhythmias may be abnormalities of ventricular muscle repolarization. In this descriptive review, we demonstrate electrocardiographic markers of ventricular repolarization (J point, QT/QTc/QTc-d, JT/JTc/JTc-d, ST segment, T wave and Tp-e/Tp-ed/Tp-e/QT), analyze their abnormalities in the obese population, and discuss their changes after weight loss.