Intravenous amiodarone versus verapamil for acute conversion of paroxysmal atrial fibrillation to sinus rhythm

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…Serious toxicity has been reported, including death due to bradycardia ending in cardiac arrest. 496,504,516,[527][528][529][530][531][532][533][534]537,551 8.1.5.4.2. DOFETILIDE.…”

Evidence-Based Analysis of Amiodarone Efficacy and Safety

“…Three of these trials observed a significantly higher rate of acute conversion to sinus rhythm with amiodarone: 67% versus 90%, Pϭ0.029 66 ; 71% versus 92% Pϭ 0.0048 65 ; and 77% versus 0% PϽ0.001. 71 The other 3 showed nonsignificant trends to better conversion with amiodarone: 56% versus 59%, PϭNS 68 ; 60% versus 68%, Pϭ0.532 65 ; and 75% versus 83%, PϭNS. 64 Control of ventricular rate in AF was evaluated in 2 placebocontrolled studies, both of which reported significantly lower ventricular rates with amiodarone.…”

“…There are 6 trials with nonactive control groups: 2 that formally compared intravenous amiodarone to digoxin, 66,67 3 that were placebo controlled with digoxin use in all patients, 68 -70 and 1 that compared amiodarone with intravenous verapamil. 71 Digoxin and verapamil have little efficacy for conversion of AF. Three of these trials observed a significantly higher rate of acute conversion to sinus rhythm with amiodarone: 67% versus 90%, Pϭ0.029 66 ; 71% versus 92% Pϭ 0.0048 65 ; and 77% versus 0% PϽ0.001.…”

2011 ACCF/AHA/HRS Focused Updates Incorporated Into the ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

“…373,491,492,532 The negative inotropic effects of nondihydropine calcium channel blockers might result in hypotension; caution should be used in patients with HF.…”