Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation

Abstract

Amiodarone has been demonstrated to be the most effective drug in maintaining sinus rhythm. Differences in outcomes between the anti-antiarrhythmic drugs were reported, with sotalol and possibly amiodarone increasing mortality and dronedarone possibly decreasing the incidence of serious adverse events and proarrhythmia.

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…Stosowanie chinidyny i dizopiramidu wiązało się ze wzrostem umieralności ogólnej (OR 2,39; 95% CI 1,03-5,59; liczba pacjentów, których trzeba leczyć w celu wystąpienia szkody u 1 pacjenta: 109, 95% CI 34-4985) w rocznej obserwacji [580,661], prawdopodobnie z powodu występowania komorowych zaburzeń rytmu (torsade de pointes) [580,661]. Mimo że ten efekt proarytmiczny jest częstszy podczas stosowania większych dawek, to leki te są rzadziej stosowane w celu kontroli rytmu serca u pacjentów z AF.…”

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

“…580,661 Although this pro-arrhythmic effect is more common at higher doses, they are less commonly used for rhythm control in AF. Disopyramide may be useful in 'vagally mediated' AF (e.g.…”

Economic modelling of diagnostic and treatment pathways in National Institute for Health and Care Excellence clinical guidelines: the Modelling Algorithm Pathways in Guidelines (MAPGuide) project

“…As inputs to the model, we estimated relative risks compared with placebo (Table 30), using assumed control risks from the warfarin arm of the ROCKET AF Treatment effects for the rhythm control drugs were taken from a published network meta-analysis, funded by Sanofi-Aventis to inform their submission to NICE for the appraisal of dronedarone. 179 For the model, we estimated relative risks for AF recurrence and treatment withdrawals ( Table 31). …”