We found that the size of the left atrium , presence of cardiovascular disease , and protocol s of amiodarone administration did not influence the magnitude of effect .
Serious adverse events were infrequent .
Amiodarone is effective for converting AF to sinus rhythm in a wide range of patients .
BACKGROUND Although clinicians sometimes choose amiodarone to convert atrial fibrillation ( AF ) to sinus rhythm , no current and comprehensive systematic review has summarized its effectiveness .
OBJECTIVE To review the effectiveness of amiodarone in converting AF to sinus rhythm over a 4-week period .
Conversion of recent onset paroxysmal atrial fibrillation to normal sinus rhythm: the effect of no treatment and high-dose amiodarone. A randomized, placebo-controlled study.
BACKGROUND Spontaneous conversion of recent onset paroxysmal atrial fibrillation  to  normal sinus rhythm  occurs commonly and is not affected by low-dose amiodarone treatment . METHODS In a r and omized , placebo-controlled trial of 100 patients with paroxysmal atrial fibrillation of recent onset ( < 48 h ) we compared the effects of treatment with continuous intravenous amiodarone 125 mg per hour ( total 3 g ) and intravenous placebo .  Patients in the placebo group who did not convert to normal sinus rhythm within 24 h were started on amiodarone therapy . RESULTS Conversion to normal sinus rhythm occurred within 24 h in 32 of 50 patients ( 64 % ) in the placebo group , most of whom converted within 8 h. Lower conversion rates were observed in patients with hypertension , ischaemic heart disease or congestive heart failure and in patients with echocardiographic findings of left atrial diameter above 45 mm , ejection fraction below 45 % or significant mitral regurgitation . However , in most patients these clinical or echocardiographic risk factors of decreases in conversion rate were not present . In such patients the spontaneous conversion rate was approximately 90 % . The conversion rate during 24 h of treatment in the amiodarone group was 92 % ( P=0.0017 , compared to the placebo group ) . In this group , the conversion rate was largely unaffected by baseline characteristics . Of the 18 patients who did not convert with placebo , 15 ( 85 % ) converted after being crossed over to amiodarone . All patients not responding to high-dose amiodarone were in chronic atrial fibrillation within 1 month . In patients still in atrial fibrillation after 8 h of treatment , the pulse rate decreased significantly more in the amiodarone as compared to the placebo group ( 83+/-15 vs 114+/-20 beats . min(-1 ) , P=0.0014 ) . CONCLUSION The spontaneous conversion of recent onset paroxysmal atrial fibrillation is high and approaches 90 % in specific clinical and echocardiographically defined subgroups . Intravenous high-dose amiodarone safely facilitates conversion of paroxysmal atrial fibrillation . However , such treatment should be reserved for patients with unfavourable risk factor profiles , not converting during 8 h of observation or requiring rate control
We found that the size of the left atrium , presence of cardiovascular disease , and protocol s of amiodarone administration did not influence the magnitude of effect .
Serious adverse events were infrequent .
Amiodarone is effective for converting AF to sinus rhythm in a wide range of patients .
BACKGROUND Although clinicians sometimes choose amiodarone to convert atrial fibrillation ( AF ) to sinus rhythm , no current and comprehensive systematic review has summarized its effectiveness .
OBJECTIVE To review the effectiveness of amiodarone in converting AF to sinus rhythm over a 4-week period .