open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29
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Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

Jorge Galperin, Marcelo V. Elizari, Ricardo Bonato, Raul Ledesma, Manuel Vazquez Blanco, Manuel Lago, Pablo Spada, Jorge Sanchez, Jorge Piasentin, Pablo A. Chiale
DOI: 10.5603/CJ.a2013.0152
·
Cardiol J 2014;21(4):397-404.

open access

Vol 21, No 4 (2014)
Original articles
Published online: 2014-08-29

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.

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.

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Keywords

amiodarone, atrial fibrillation, arrhythmia-sinus rhythm maintenance

About this article
Title

Short-term amiodarone therapy after reversion of persistent atrial fibrillation reduces recurrences at 18 months

Journal

Cardiology Journal

Issue

Vol 21, No 4 (2014)

Pages

397-404

Published online

2014-08-29

DOI

10.5603/CJ.a2013.0152

Bibliographic record

Cardiol J 2014;21(4):397-404.

Keywords

amiodarone
atrial fibrillation
arrhythmia-sinus rhythm maintenance

Authors

Jorge Galperin
Marcelo V. Elizari
Ricardo Bonato
Raul Ledesma
Manuel Vazquez Blanco
Manuel Lago
Pablo Spada
Jorge Sanchez
Jorge Piasentin
Pablo A. Chiale

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