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Amiodarone as a first choice drug
ArticleCopyright ArticleGrants
: Biomed Central Ltd2001 :
-
ArticleHistory
Niall Mulvahill,Aff1
Corresponding Affiliation: Aff1
Context
Chronic atrial fibrillayion, class III drugs, medical cardioversion
This paper describes a prospective randomised controlled study to assess the effectiveness of
amiodarone in converting both short-term and long-lasting atrial fibrillation (AF) after 30 days of
treatment.
This research was undertaken because of conflicting reports on the effectiveness (16%-19%) of
amiodarone in the conversion of A F. This study also mandated that amiodarone was used as first line
drug treatment.
Significant findings
Overall, 80.5% of the amiodarone group and 40% of the placebo group converted to sinus rhythm at
30 days
Comments
I found this article interesting because of the high success rate of conversion to sinus rhythm with
amiodarone treatment in patients with increased left atrial size (46 mm; 61%) and those with chronic AF
(35%). In accordance with other reports the longer duration of amiodarone treatment is associated with
higher conversion rates in patients with chronic AF.
Possible implications of these findings are that prolonged use of amiodarone could be recommended
in patients with dilated left atria and chronic AF after initial Failure of chemical cardioversion. For
patients with recent onset AF with normal atrial size, the conversion rate to sinus rhythm with digoxin
was >90%; suggesting that amiodarone is not necessary for the majority of this patient subgroup.
Methods
Patients received intravenous (24 h) followed by oral amiodarone or placebo. All patients received
digoxin for the first 24 h. .
Additional information
This PDF file was created after publication.
1. Vardos PE , Kochiadakis GE , Igoumenidis NE , Tsatsakis AM , Simantriakis EN , Chlouverakis GI : Amiodarone as a first choice drug for restoring sinus rhythm in patients with atrial fibrillation . Chest . 2000 , 17 : 1538 - 1545 . (...truncated)