Author, as appears in the article.: El Amrani, Amine; Vinolas, Xavier; Arias, Miguel Angel; Bazan, Victor; Valdovinos, Pilar; Alegret, Josep M.;

Department: Medicina i Cirurgia

URV's Author/s: Alegret Colomé, Josep Maria

Keywords: 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

Abstract: 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.

Thematic Areas: Medicine, general & internal Medicine (miscellaneous) Medicine (all)

licence for use: https://creativecommons.org/licenses/by/3.0/es/

Author's mail: josepmaria.alegret@urv.cat

Author identifier: 0000-0002-6117-5512

Record's date: 2023-02-19

Papper version: info:eu-repo/semantics/publishedVersion

Link to the original source: https://www.mdpi.com/2077-0383/10/5/1029

Licence document URL: http://repositori.urv.cat/ca/proteccio-de-dades/

Papper original source: Journal Of Clinical Medicine. 10 (5): 1-8

APA: El Amrani, Amine; Vinolas, Xavier; Arias, Miguel Angel; Bazan, Victor; Valdovinos, Pilar; Alegret, Josep M.; (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

Article's DOI: 10.3390/jcm10051029

Entity: Universitat Rovira i Virgili

Journal publication year: 2021

Publication Type: Journal Publications