Pharmacological cardioversion after pre-treatment with antiarrythmic drugs prior to electrical cardioversion in persistent atrial fibrillation : Impact on maintenance of sinus rhythm
El Amrani, Amine (Hospital Universitari Joan XXIII de Tarragona. Institut d'Investigació Sanitària Pere Virgili)
Viñolas, Xavier (Institut d'Investigació Biomèdica Sant Pau)
Arias, Miguel Ángel (Hospital Virgen de la Salud (Toledo))
Bazán, Víctor (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Valdovinos, Pilar (Hospital Universitari Joan XXIII de Tarragona. Institut d'Investigació Sanitària Pere Virgili)
Alegret i Colomé, Josep Maria (Hospital Universitari Joan XXIII de Tarragona. Institut d'Investigació Sanitària Pere Virgili)

Date:	2021
Abstract:	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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Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Atrial fibrillation ; Electrical cardioversion ; Pharmacological cardioversion ; Antiarrhythmic drugs
Published in:	Journal of clinical medicine, Vol. 10 Núm. 5 (january 2021) , p. 1-8, ISSN 2077-0383

DOI: 10.3390/jcm10051029
PMID: 33802253

8 p, 429.8 KB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut de Recerca Sant Pau
Articles > Research articles
Articles > Published articles