Articles producció científica> Medicina i Cirurgia

Utility of Amiodarone Pre-Treatment as a Facilitator of the Acute Success of Electrical Cardioversion in Persistent Atrial Fibrillation

  • Identification data

    Identifier: imarina:6185071
    Authors:
    Alegret, JMViñolas, XTajes, HValdovinos, PPalomares, RArias, MABazán, V
    Abstract:
    Purpose The usefulness and mechanisms of antiarrhythmic drug (AAD) pre-treatment as a facilitator of the acute success of electrical cardioversion (ECV) in atrial fibrillation (AF) remain controversial. We sought to analyze the role of AAD treatment with this purpose, differentiating its possible utility either facilitating the restoration of sinus rhythm (SR) or reducing immediate AF recurrences (IAFR). Methods We analyzed 2962 consecutive patients with persistent AF undergoing ECV prospectively included in 3 national registries. The acute success of ECV was indicated by the reversion to SR without presenting an IAFR (< 2 h). Results A total of 1410 patients (48%) received AAD treatment prior to ECV (80% amiodarone, 15% class Ic AAD, 2% other AAD). The rate of restoration of SR was similar between the patients treated with amiodarone (92%), class Ic AAD (91%) and who did not receive AAD pre-treatment (91%) (p = 0.92). However, those treated with amiodarone had fewer IAFR than those in the other two groups (amiodarone 3% vs class Ic 7% vs without treatment 6%; p = 0.002), so the ECV success rate was higher in the amiodarone group than in the other groups (amiodarone 89% vs Ic 84% vs without treatment 86%; p = 0.04). After adjusting for multiple variables, amiodarone remained as an independent predictor of a lower occurrence of IAFR (OR = 0.57; p = 0.01) and of a successful ECV (OR 1.37; p = 0.01). Conclusions For patients with persistent AF undergoing ECV, AAD has a neutral effect on the restoration of SR but amiodarone increases its effectiveness due to a lower incidence of IAFR.
  • Others:

    Author, as appears in the article.: Alegret, JM; Viñolas, X; Tajes, H; Valdovinos, P; Palomares, R; Arias, MA; Bazán, V
    Department: Medicina i Cirurgia
    URV's Author/s: Alegret Colomé, Josep Maria / Palomares Bonet, Raquel / Tajes Pascual, Hernan Eduardo / Valdovinos Perdices, Maria del Pilar
    Keywords: Therapy Term Sinus rhythm Oral amiodarone Maintenance Flecainide Electropharmacology Electrical cardioversion Efficacy Class ic Atrial fibrillation Antiarrhythmic drugs Amiodarone class ic atrial fibrillation antiarrhythmic drugs amiodarone
    Abstract: Purpose The usefulness and mechanisms of antiarrhythmic drug (AAD) pre-treatment as a facilitator of the acute success of electrical cardioversion (ECV) in atrial fibrillation (AF) remain controversial. We sought to analyze the role of AAD treatment with this purpose, differentiating its possible utility either facilitating the restoration of sinus rhythm (SR) or reducing immediate AF recurrences (IAFR). Methods We analyzed 2962 consecutive patients with persistent AF undergoing ECV prospectively included in 3 national registries. The acute success of ECV was indicated by the reversion to SR without presenting an IAFR (< 2 h). Results A total of 1410 patients (48%) received AAD treatment prior to ECV (80% amiodarone, 15% class Ic AAD, 2% other AAD). The rate of restoration of SR was similar between the patients treated with amiodarone (92%), class Ic AAD (91%) and who did not receive AAD pre-treatment (91%) (p = 0.92). However, those treated with amiodarone had fewer IAFR than those in the other two groups (amiodarone 3% vs class Ic 7% vs without treatment 6%; p = 0.002), so the ECV success rate was higher in the amiodarone group than in the other groups (amiodarone 89% vs Ic 84% vs without treatment 86%; p = 0.04). After adjusting for multiple variables, amiodarone remained as an independent predictor of a lower occurrence of IAFR (OR = 0.57; p = 0.01) and of a successful ECV (OR 1.37; p = 0.01). Conclusions For patients with persistent AF undergoing ECV, AAD has a neutral effect on the restoration of SR but amiodarone increases its effectiveness due to a lower incidence of IAFR.
    Thematic Areas: Pharmacology (medical) Pharmacology & pharmacy Pharmacology Medicine (miscellaneous) Medicina ii Medicina i Farmacia Educação física Ciências biológicas ii Ciências biológicas i Cardiology and cardiovascular medicine Cardiac & cardiovascular systems
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    ISSN: 09203206
    Author's mail: hernaneduardo.tajes@urv.cat mariadelpilar.valdovinos@urv.cat josepmaria.alegret@urv.cat
    Author identifier: 0000-0002-6117-5512
    Record's date: 2024-02-10
    Papper version: info:eu-repo/semantics/acceptedVersion
    Link to the original source: https://link.springer.com/article/10.1007%2Fs10557-019-06934-5
    Papper original source: Cardiovascular Drugs And Therapy. 34 (1): 89-94
    APA: Alegret, JM; Viñolas, X; Tajes, H; Valdovinos, P; Palomares, R; Arias, MA; Bazán, V (2020). Utility of Amiodarone Pre-Treatment as a Facilitator of the Acute Success of Electrical Cardioversion in Persistent Atrial Fibrillation. Cardiovascular Drugs And Therapy, 34(1), 89-94. DOI: 10.1007/s10557-019-06934-5
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Article's DOI: 10.1007/s10557-019-06934-5
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2020
    Publication Type: Journal Publications
  • Keywords:

    Cardiac & Cardiovascular Systems,Cardiology and Cardiovascular Medicine,Medicine (Miscellaneous),Pharmacology,Pharmacology & Pharmacy,Pharmacology (Medical)
    Therapy
    Term
    Sinus rhythm
    Oral amiodarone
    Maintenance
    Flecainide
    Electropharmacology
    Electrical cardioversion
    Efficacy
    Class ic
    Atrial fibrillation
    Antiarrhythmic drugs
    Amiodarone
    class ic
    atrial fibrillation
    antiarrhythmic drugs
    amiodarone
    Pharmacology (medical)
    Pharmacology & pharmacy
    Pharmacology
    Medicine (miscellaneous)
    Medicina ii
    Medicina i
    Farmacia
    Educação física
    Ciências biológicas ii
    Ciências biológicas i
    Cardiology and cardiovascular medicine
    Cardiac & cardiovascular systems
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