Author, as appears in the article.: Alegret, Josep M; Vinolas, Xavier; Tajes, Hernan; Valdovinos, Pilar; Palomares, Raquel; Arias, Miguel A; Bazan, Victor
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: Treatment outcome Time factors Therapy Term Spain Sinus rhythm Risk factors Retrospective studies Registries Recurrence Oral amiodarone Middle aged Male Maintenance Humans Heart rate Flecainide Female Electropharmacology Electrical cardioversion Electric countershock Efficacy Class ic Atrial fibrillation Antiarrhythmic drugs Anti-arrhythmia agents Amiodarone Aged 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: 2025-02-24
Paper version: info:eu-repo/semantics/acceptedVersion
Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
Paper 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
Entity: Universitat Rovira i Virgili
Journal publication year: 2020
Publication Type: Journal Publications
Repositori URV