8669cea4b8984170c33ae1b291f9855e 272103.pdf 60fafadab9775dd78f3f1bc8f466ef146fa117cf 272103.pdf 87b86bc1a6a169f0a24ccceb49d8459364714cb1ddec74c58901038d76cbade7 272103.pdf Title: Pharmacological Cardioversion after Pre-Treatment with Antiarrythmic Drugs Prior to Electrical Cardioversion in Persistent Atrial Fibrillation: Impact on Maintenance of Sinus Rhythm Subject: 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. Keywords: atrial fibrillation; electrical cardioversion; pharmacological cardioversion; antiarrhythmic drugs Author: Amine El Amrani, Xavier Viñolas, Miguel Angel Arias, Victor Bazan, Pilar Valdovinos and Josep M. Alegret Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Wed Mar 3 09:35:17 2021 CET ModDate: Wed Mar 3 09:40:40 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 8 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 440066 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- UKCGCI+URWPalladioL-Ital Type 1 Custom yes yes no 10 0 TLDXHB+URWPalladioL-Bold Type 1 Custom yes yes no 15 0 QPSAVK+URWPalladioL-Roma Type 1 Custom yes yes no 19 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 27 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 30 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 52 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 56 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 60 0 JGMOZW+CMSY10 Type 1 Builtin yes yes no 72 0 WBVKDJ+URWPalladioL-BoldItal Type 1 Custom yes yes no 89 0 JACWOG+PalatinoLinotype-Italic TrueType WinAnsi yes yes yes 98 0 REFXWQ+PalatinoLinotype-Bold TrueType WinAnsi yes yes yes 102 0 BBDFGW+PalatinoLinotype-Roman TrueType WinAnsi yes yes yes 106 0 RUBSWQ+PalatinoLinotype-BoldItalic TrueType WinAnsi yes yes yes 110 0 NCUGIZ+VnURWPalladioL Type 1 Custom yes yes no 125 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-27 02:59:59 CEST RepresentationInformation: 272103.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2023-03-31 12:05:22 CEST Size: 440066 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 223 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Introduction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Materials and Methods Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Results Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: Discussion Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Info: Title: Pharmacological Cardioversion after Pre-Treatment with Antiarrythmic Drugs Prior to Electrical Cardioversion in Persistent Atrial Fibrillation: Impact on Maintenance of Sinus Rhythm Author: Amine El Amrani, Xavier Viñolas, Miguel Angel Arias, Victor Bazan, Pilar Valdovinos and Josep M. Alegret Subject: 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. 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