Chest
Clinical InvestigationsCARDIOLOGYAmiodarone as a First-Choice Drug for Restoring Sinus Rhythm in Patients With Atrial Fibrillation
Section snippets
Patients
Two-hundred eight consecutive patients (102 men and 106 women) aged 27 to 78 years (mean [± SD], 65 ± 10 years), with symptoms of atrial fibrillation, who came to the emergency department or were treated in our clinic, were included in this study. Patients with a recent myocardial infarction, heart surgery within the last 6 months, unstable angina, acute myocarditis, acute pericarditis, severe uncontrolled heart failure (ejection fraction < 30%), or cardiogenic shock were excluded, as were
Results
Of the 208 patients who were enrolled, 108 patients were randomized to amiodarone and 100 to placebo treatment. There were no significant differences between the amiodarone and placebo groups in baseline patient characteristics (Table 1). Echocardiographic studies were performed in 97 patients while they were in atrial fibrillation (37 receiving amiodarone and 60 receiving placebo treatment), and in 111 patients while they were in sinus rhythm (within 24 h after conversion). In 31 patients,
Discussion
According to our findings, a patient receiving amiodarone has six times better odds of converting to sinus rhythm than a patient receiving placebo treatment. However, factors such as the duration of the arrhythmia and the size of the left atrium appear to influence the conversion rate of amiodarone, mainly in extreme cases. The overall conversion rate of amiodarone is very high (> 90%), but in patients with a very large left atrium and chronic atrial fibrillation, the rate falls to relatively
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Effect of perioperative intravenous amiodarone on cardioversion of atrial fibrillation early after video-assisted thoracoscopic surgical ablation: Study protocol for a double-blind randomized controlled trial
2022, Contemporary Clinical Trials CommunicationsCitation Excerpt :Of all antiarrhythmic drugs currently used in AF, amiodarone has the greatest potential to maintain sinus rhythm [15,16]. The study of Vardas et al. presented that restoration of sinus rhythm in patients after one-month receiving amiodarone therapy is twice that of patients treated with placebo (80.05% vs 40%, p < 0.0001) [17]. Compared with other antiarrhythmic drugs, amiodarone can be safely administered in severe heart failure [18], coronary artery disease [19] and left ventricular hypertrophy.
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