Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

Galperin, Jorge; Elizari, Marcelo V.; Bonato, Ricardo; Ledesma, Raúl; Blanco, Manuel Vázquez; Lago, Manuel; Spada, Pablo; Sánchez, Jorge Sanz; Piasentin, Jorge A.; Chiale, Pablo A.

doi:10.5603/cj.a2013.0152

Cited by 6 publications

(6 citation statements)

References 28 publications

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“…The plot in our study was symmetrical and roughly funnel-form in shape, but does not allow us to exclude all potential biases for the following reasons: 1) We could not elaborate on all diseases that cause AF mentioned in the included 31 articles. For instance valvular heart disease [5,8,10,12,17,20,22,23,26,29,34], hypertensive heart disease [10,12,20,22,25,26,28,30,[32][33][34], coronary heart disease [10,12,20,22,25,26,[28][29][30][32][33][34], and dilated cardiomyopathy [12,28]were treated differently. More specifically, coronary heart disease was treated with lipid-lowering and antiplatelet drugs, and hypertension was treated with pressure reducing drugs.2) AF classification was randomly mixed in the included 31 articles, and the literature included a collection of paroxysmal AF [4,7,9,10,13,14,18,20,…”

Section: Discussionmentioning

confidence: 99%

“…We read the full-text and abstracts of the remaining 186 studies, and identified 31 eligible articles . Among these, 24 were in Chinese and the remaining 7 were in English [28][29][30][31][32][33][34] (Fig. 1).…”

Section: Retrieval Strategymentioning

confidence: 99%

“…The literature refers to paroxysmal, persistent, and permanent AF, as reported in the references provided here: paroxyxmal AF [4,7,9,10,13,14,18,20,22,24,31,32], persistent AF [5-7, 15, 16, 22, 25, 26, 28], and permanent AF [7]. Duration of AF was explained in [4, 6, 8, 14-16, 18, 22, 23, 26-30, 32-34], and was referred to as AF pathogeny as follows: valvular heart disease [5,8,10,12,17,20,22,23,26,29,34], hypertensive heart disease [10,12,20,22,25,26,28,30,[32][33][34], coronary heart disease [10,12,20,22,25,26,[28][29][30][32][33][34], and dilated cardi...…”

Section: Document Characterizationmentioning

confidence: 99%

“…Duration of AF was explained in [4, 6, 8, 14-16, 18, 22, 23, 26-30, 32-34], and was referred to as AF pathogeny as follows: valvular heart disease [5,8,10,12,17,20,22,23,26,29,34], hypertensive heart disease [10,12,20,22,25,26,28,30,[32][33][34], coronary heart disease [10,12,20,22,25,26,[28][29][30][32][33][34], and dilated cardiomyopathy [12,28]. The general quality grade of the studies was B [28][29][30][31][32]; in a few exceptions the grade was C [4-27, 33, 34] (Table.1).…”

Section: Document Characterizationmentioning

confidence: 99%

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Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis

Yang

Xue

et al. 2019

Preprint

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Background Class III anti-arrhythmic drugs (AADs) are used to control heart rhythm or rate in the management of atrial fibrillation (AF). In this study, we evaluated the most effective and safe class III AADs used to treat patients with AF. Methods We searched the PubMed, Cochrane Library, Web of Science, Embase, WanFang databases, as well as the China National Knowledge Infrastructure from 2014 to 2019 to identify studies that reported the use of class III ADDs to treat AF. Results We identified 31 articles (24 Chinese and 7 English), that included 2,894 AF patients (treatment group = 1,498, control group = 1,396) for our analysis. Several class III AADs showed significant treatment effects in AF patients compared to conventional treatment. The ADDs were ranked in terms of efficacy from good to bad as follows: vernakalant (relative risk (RR) =2.7, 95% confidence interval (CI):1.9-3.7), ibutilide (RR=2.0, 95% CI:1.7-2.4), nifekalant (RR=1.5, 95% CI:1.2-2.0), and amiodarone (RR=1.4,95% CI:1.3-1.5). There were no significant differences in the incidence of adverse reactions among the different class III AADs. These ADDs were ranked from least to most adverse reactions as follows: vernakalant(RR=0.46, 95% CI:0.20-1.0), sotalol (RR=0.52, 95% CI:0.25-1.0), ibutilide (RR=0.64, 95% CI:0.33-1.2), amiodarone (RR=0.79, 95% CI:0.58-1.1), and nifekalant (RR=1.0, 95% CI:0.44-2.5). Conclusion Our network meta-analysis shows that different class III AADs can be used to treat patients with AF both safely and effectively. Vernakalant appears to offer optimal therapeutic effect with minimal adverse reactions.

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Section: Discussionmentioning

confidence: 99%

Section: Retrieval Strategymentioning

confidence: 99%

Section: Document Characterizationmentioning

confidence: 99%

Section: Document Characterizationmentioning

confidence: 99%

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Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis

Yang

Xue

et al. 2019

Preprint

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“…60 In patients regaining sinus rhythm after the first episode of persistent AF, three months of AM therapy after reversion is a reasonable option for rhythm control, with significantly lower recurrences after 18 months. 61 The superior efficacy of this drug is partially overshadowed by the adverse effects that occur in 15 to 50% of cases, from the first year of treatment to prolonged treatment. Cardiac, pulmonary, thyroid and hepatic side effects are well known.…”

Section: The Use Of Am In Patients With Afmentioning

confidence: 99%

Remodelling in atrial fibrillation: the impact of amiodarone

Grosu

Rădulescu

Grosu

et al. 2019

CVJA

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Atrial fibrillation (AF) is a common heart rhythm disorder with a prevalence of up to 2.9% in the general population. Its mechanism involves a particular electrophysiological profile as well as structural and biohumoral changes that are often irreversible. With the recent advances in pharmacology, amiodarone remains the cornerstone for the treatment of AF. Although it is one of the most controversial anti-arrhythmic agents due to the multitude of side effects, it is further recognised as the most effective drug available for the conversion and maintenance of sinus rhythm in the case of significant left ventricular dysfunction or severe aortic stenosis. This quality is provided by its multivalent profile, with a complex electrophysiological activity overlapped with an anti-inflammatory and vasodilatory effect. This review aims to outline the main structural and functional changes in AF and the multisite impact of amiodarone on its treatment.

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Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation

Lafuente-Lafuente

Valembois

Bergmann

et al. 2015

Cochrane Database of Systematic Reviews

202

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BackgroundAtrial fibrillation is the most frequent sustained arrhythmia. Atrial fibrillation frequently recurs after restoration of normal sinus rhythm. Antiarrhythmic drugs have been widely used to prevent recurrence, but the effect of these drugs on all-cause mortality and other clinical outcomes is unclear. This is an update of a review previously published in 2007, 2012 and 2015. risk of mortality was higher in people taking quinidine, although the confidence interval also includes the possibility of no difference (RR 2.01, 95% CI 0.84 to 4.77; participants = 1646).No effect on mortality was apparent with the remaining drugs studied, but less data was available for them and it could be underpowered to detect small increases in mortality. In particular, very few data was available for flecainide (no death reported in any treatment arm in 4 RCTs studying flecainide, participants = 511) and propafenone (only 2 deaths reported in 5 included RCTs, participants = 998).

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Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

Abstract: Background: The aim of this study was to compare the outcome of 3 months vs. 18 months of amiodarone treatment after atrial fibrillation (AF) conversion in patients who (Cardiol J 2014; 21, 4: 397-404)

Cited by 6 publications

References 28 publications

Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis

Evaluation of the efficacy and safety of different class III anti-arrhythmic drugs for treating patients with atrial fibrillation: a network meta-analysis

Remodelling in atrial fibrillation: the impact of amiodarone

Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation

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