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 .
Effects of diltiazem pretreatment on direct-current cardioversion in patients with persistent atrial fibrillation: a single-blind, randomized, controlled study.
BACKGROUND Electric conversion of atrial fibrillation is the most widely used and effective treatment for sinus rhythm restoration . However , it has a limited success rate and a high recurrence rate . HYPOTHESIS Pretreatment with calcium channel blocker may improve the efficacy by reversing the so-called " electric remodeling " phenomenon , also related to overload in cytosolic calcium . METHODS The efficacy of diltiazem or amiodarone pretreatment ( oral , 1 month before and 1 month after conversion ) on direct-current conversion of persistent atrial fibrillation was assessed in 120 patients , r and omly assigned to 3 matched groups : A ( n = 44 , diltiazem ) ; B ( n = 46 , amiodarone ) , and C ( n = 30 , digoxin ) . RESULTS Before electric conversion , all treatments significantly decreased mean heart rate . Spontaneous conversion to sinus rhythm was achieved in 6 % of patients of group A ( 3 of 46 ) versus 25 % of group B ( 11 of 44 ) and 3 % ( 1 of 30 ) of group C ( A/C vs B , P < .005 ) . Current conversion was more successful in group B ( 91 % ) compared with group A ( 76 % ) and group C ( 67 % ) ( B vs A/C , P < .05 ) , with no difference in the electric threshold for effective conversion ( P = not significant ) . At the 24-hour time point , early relapse of atrial fibrillation was similar between groups A and B ( A , 2 % ; B , 3 % ; P = not significant ) and lower than group C ( 12 % ) ( P < .01 ) , whereas at the 1-month time point the recurrence rate was lower in group B ( 28 % ) versus groups A ( 56 % ) and C ( 78 % ) ( B vs A/C , P < .01 ) . No significant side effects were reported . CONCLUSIONS Although diltiazem seems to be as effective as amiodarone in reducing early atrial fibrillation recurrences , diltiazem is less effective in determining spontaneous or electric conversion , with a higher recurrence rate at 2 months . Diltiazem pretreatment could be considered as only a second choice treatment in those patients in whom amiodarone is contraindicated
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 .