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Pharmacological Cardioversion after Pre-Treatment with Antiarrythmic Drugs Prior to Electrical Cardioversion in Persistent Atrial Fibrillation: Impact on Maintenance of Sinus Rhythm

  • Dades identificatives

    Identificador: imarina:9177878
    Autors:
    El Amrani, AViñolas, XArias, MABazan, VValdovinos, PAlegret, JM
    Resum:
    Background: Antiarrhythmic drugs (AADs) are frequently initiated in patients with persistent atrial fibrillation (AF) prior to electrical cardioversion (ECV), achieving pharmacological cardioversion (PCV) in some cases. Little is known about the mode of cardioversion and the effect of the type of AAD used in the maintenance of sinus rhythm (SR). Methods: From three national surveys of patients with persistent AF referred for ECV, we selected those who were pre-treated with AADs (amiodarone or group Ic AADs). We analyzed the effect of the type of cardioversion (pharmacological vs. electrical) and the AAD used in the maintenance of SR at three months. Results: Among the 665 patients selected, 151 had a successful PCV prior to the planned ECV. In the remaining 514 patients, 460 had a successful ECV. A successful PCV was related to a higher rate of SR maintenance than a successful ECV (77.9% vs. 57.5%; p < 0.0001). After a successful PCV, the maintenance of SR was identical in those patients treated with amiodarone and those treated with group Ic AADs (77.4% vs. 77.5%; p = 0.99), whereas after a successful ECV, amiodarone was clearly superior to group Ic AADs (61.3% vs. 43.0%; p = 0.001). Considering patients with successful PCV and ECV together, PCV was an independent factor related to the maintenance of SR. Conclusions: In patients with persistent AF, successful PCV selects a subgroup with a high probability of maintenance of SR. With regard to drugs, amiodarone was superior to group Ic AADs in patients with ECV, whereas in PCV, no differences were observed.
  • Altres:

    Autor segons l'article: El Amrani, A; Viñolas, X; Arias, MA; Bazan, V; Valdovinos, P; Alegret, JM
    Departament: Medicina i Cirurgia
    Autor/s de la URV: Alegret Colomé, Josep Maria / El Amrani Rami, Amine
    Paraules clau: Valvular heart disease Sinus rhythm Pharmacological cardioversion Persistent atrial fibrillation Middle aged Medical history Male Major clinical study Hypertension Human Heart left ventricle hypertrophy Heart left ventricle ejection fraction Heart infarction Heart disease Follow up Female Electrical cardioversion Dipeptidyl carboxypeptidase inhibitor Diabetes mellitus Comparative effectiveness Clinical feature Chronic obstructive lung disease Cardioversion Cardiomyopathy Body mass Atrial fibrillation Article Antiarrhythmic drugs Antiarrhythmic agent Angiotensin receptor antagonist Amiodarone Adult
    Resum: Background: Antiarrhythmic drugs (AADs) are frequently initiated in patients with persistent atrial fibrillation (AF) prior to electrical cardioversion (ECV), achieving pharmacological cardioversion (PCV) in some cases. Little is known about the mode of cardioversion and the effect of the type of AAD used in the maintenance of sinus rhythm (SR). Methods: From three national surveys of patients with persistent AF referred for ECV, we selected those who were pre-treated with AADs (amiodarone or group Ic AADs). We analyzed the effect of the type of cardioversion (pharmacological vs. electrical) and the AAD used in the maintenance of SR at three months. Results: Among the 665 patients selected, 151 had a successful PCV prior to the planned ECV. In the remaining 514 patients, 460 had a successful ECV. A successful PCV was related to a higher rate of SR maintenance than a successful ECV (77.9% vs. 57.5%; p < 0.0001). After a successful PCV, the maintenance of SR was identical in those patients treated with amiodarone and those treated with group Ic AADs (77.4% vs. 77.5%; p = 0.99), whereas after a successful ECV, amiodarone was clearly superior to group Ic AADs (61.3% vs. 43.0%; p = 0.001). Considering patients with successful PCV and ECV together, PCV was an independent factor related to the maintenance of SR. Conclusions: In patients with persistent AF, successful PCV selects a subgroup with a high probability of maintenance of SR. With regard to drugs, amiodarone was superior to group Ic AADs in patients with ECV, whereas in PCV, no differences were observed.
    Àrees temàtiques: Medicine, general & internal Medicine (miscellaneous) Medicine (all)
    Accès a la llicència d'ús: https://creativecommons.org/licenses/by/3.0/es/
    Adreça de correu electrònic de l'autor: josepmaria.alegret@urv.cat
    Identificador de l'autor: 0000-0002-6117-5512
    Data d'alta del registre: 2024-07-27
    Versió de l'article dipositat: info:eu-repo/semantics/publishedVersion
    Enllaç font original: https://www.mdpi.com/2077-0383/10/5/1029
    URL Document de llicència: https://repositori.urv.cat/ca/proteccio-de-dades/
    Referència a l'article segons font original: Journal Of Clinical Medicine. 10 (5): 1-8
    Referència de l'ítem segons les normes APA: El Amrani, A; Viñolas, X; Arias, MA; Bazan, V; Valdovinos, P; Alegret, JM (2021). Pharmacological Cardioversion after Pre-Treatment with Antiarrythmic Drugs Prior to Electrical Cardioversion in Persistent Atrial Fibrillation: Impact on Maintenance of Sinus Rhythm. Journal Of Clinical Medicine, 10(5), 1-8. DOI: 10.3390/jcm10051029
    DOI de l'article: 10.3390/jcm10051029
    Entitat: Universitat Rovira i Virgili
    Any de publicació de la revista: 2021
    Tipus de publicació: Journal Publications
  • Paraules clau:

    Medicine (Miscellaneous),Medicine, General & Internal
    Valvular heart disease
    Sinus rhythm
    Pharmacological cardioversion
    Persistent atrial fibrillation
    Middle aged
    Medical history
    Male
    Major clinical study
    Hypertension
    Human
    Heart left ventricle hypertrophy
    Heart left ventricle ejection fraction
    Heart infarction
    Heart disease
    Follow up
    Female
    Electrical cardioversion
    Dipeptidyl carboxypeptidase inhibitor
    Diabetes mellitus
    Comparative effectiveness
    Clinical feature
    Chronic obstructive lung disease
    Cardioversion
    Cardiomyopathy
    Body mass
    Atrial fibrillation
    Article
    Antiarrhythmic drugs
    Antiarrhythmic agent
    Angiotensin receptor antagonist
    Amiodarone
    Adult
    Medicine, general & internal
    Medicine (miscellaneous)
    Medicine (all)
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