1. Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months.
- Author
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Galperin J, Elizari MV, Bonato R, Ledesma R, Vazquez Blanco M, Lago M, Spada P, Sanchez J, Piasentin J, and Chiale PA
- Subjects
- Aged, Aged, 80 and over, Argentina, Atrial Fibrillation diagnosis, Atrial Fibrillation physiopathology, Bayes Theorem, Combined Modality Therapy, Disease-Free Survival, Double-Blind Method, Drug Administration Schedule, Echocardiography, Doppler, Electrocardiography, Ambulatory, Female, Heart Conduction System physiopathology, Humans, Kaplan-Meier Estimate, Male, Middle Aged, Recurrence, Time Factors, Treatment Outcome, Amiodarone administration & dosage, Anti-Arrhythmia Agents administration & dosage, Atrial Fibrillation therapy, Electric Countershock adverse effects, Heart Conduction System drug effects, Heart Rate drug effects
- Abstract
Background: The aim of this study was to compare the outcome of 3 months vs. 18 months of amiodarone treatment after atrial fibrillation (AF) conversion in patients who experienced the first episode of persistent AF., Methods: We included 51 patients who experienced the first episode of persistent AF receiving amiodarone (600 mg) daily for 4-6 weeks. If AF persisted, electrical cardioversion (ECV) was performed. All patients received amiodarone (200 mg daily) for 3 months and then were randomized to amiodarone (Group I) or placebo (Group II) and followed for 15 months. The control group comprised 9 untreated patients undergoing ECV. Treatment effectiveness was evaluated using a Bayesian model., Results: Eighteen months after AF reversion, 22 (81.5%) patients in Group I, 13 (54.2%) patients in Group II, and 1 (11.1%) patient in the control group remained in sinus rhythm. No differences were found between Group I patients who required ECV and Group II patients. Sinus rhythm was preserved in all Group I patients when it was achieved during amiodarone administration. Limiting adverse effects occurred in 3 (11.1%) patients in Group I., Conclusions: In patients regaining sinus rhythm after the first episode of persistent AF, a 3-month amiodarone treatment after reversion is a reasonable option for rhythm control.
- Published
- 2014
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