Bayesian network meta- analysis using a r and om-effects model demonstrated that ranolazine + amiodarone intravenous ( IV ) [ odds ratio ( OR ) 39.8 , 95 % credible interval ( CrI ) 8.3 - 203.1 ] , vernakalant ( OR 22.9 , 95 % CrI 3.7 - 146.3 ) , flecainide ( OR 16.9 , 95 % CrI 4.1 - 73.3 ) , amiodarone oral ( OR 10.2 , 95 % CrI 3.1 - 36.0 ) , ibutilide ( OR 7.9 , 95 % CrI 1.2 - 52.5 ) , amiodarone IV ( OR 5.4 , 95 % CrI 2.1 - 14.6 ) , and propafenone ( OR 4.1 , 95 % CrI 1.7 - 10.5 ) were associated with significantly increased likelihood of conversion within 24 h when compared to placebo/control .
Probabilistic analysis ranked vernakalant and flecainide high and propafenone and amiodarone IV low .
For pharmacologic cardioversion of recent-onset AF within 24 h , there is insufficient evidence to determine which treatment is superior .
Vernakalant and flecainide may be relatively more efficacious agents .
Propafenone and IV amiodarone may be relatively less efficacious .
AIMS We sought to identify the most effective antidysrhythmic drug for pharmacologic cardioversion of recent-onset atrial fibrillation ( AF ) .
A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent-onset atrial fibrillation.
The appropriate treatment for the restoration of sinus rhythm in patients with atrial fibrillation ( AF ) of recent onset is still the subject of controversy . In this prospect i ve , r and omized , single-blind , placebo-controlled clinical study , we investigated the effectiveness and safety of procainamide , propafenone , and amiodarone , administered intravenously , for the conversion of recent-onset AF . We enrolled 362 consecutive patients ( 183 men ; age 34 to 86 years ; mean 65+/-10 ) with AF duration of no > 48 hours . Of these patients , 89 were given procainamide , 91 propafenone , 92 amiodarone , and 90 placebo . Treatment was considered successful if conversion to sinus rhythm was achieved within the 24-hour study period . Baseline clinical characteristics were similar in the 4 groups . The treatment was successful in 61 of the 89 patients who received procainamide ( 68.53 % ; median time 3 hours ) , 73 of the 91 patients who received propafenone ( 80.21 % ; median time 1 hour ) , 82 of the 92 patients who received amiodarone ( 89.13 % ; median time 9 hours ) , and 55 of the 90 patients who received placebo ( 61.11 % ; median time 17 hours ; p<0.05 for all medicated groups vs placebo ; p<0.05 for amiodarone and propafenone vs procainamide ) . In conclusion , all 3 medications , when administered intravenously , are effective in the restoration of sinus rhythm in recent-onset AF . Amiodarone and propafenone are more effective whereas procainamide and propafenone are faster
Bayesian network meta- analysis using a r and om-effects model demonstrated that ranolazine + amiodarone intravenous ( IV ) [ odds ratio ( OR ) 39.8 , 95 % credible interval ( CrI ) 8.3 - 203.1 ] , vernakalant ( OR 22.9 , 95 % CrI 3.7 - 146.3 ) , flecainide ( OR 16.9 , 95 % CrI 4.1 - 73.3 ) , amiodarone oral ( OR 10.2 , 95 % CrI 3.1 - 36.0 ) , ibutilide ( OR 7.9 , 95 % CrI 1.2 - 52.5 ) , amiodarone IV ( OR 5.4 , 95 % CrI 2.1 - 14.6 ) , and propafenone ( OR 4.1 , 95 % CrI 1.7 - 10.5 ) were associated with significantly increased likelihood of conversion within 24 h when compared to placebo/control .
Probabilistic analysis ranked vernakalant and flecainide high and propafenone and amiodarone IV low .
For pharmacologic cardioversion of recent-onset AF within 24 h , there is insufficient evidence to determine which treatment is superior .
Vernakalant and flecainide may be relatively more efficacious agents .
Propafenone and IV amiodarone may be relatively less efficacious .
AIMS We sought to identify the most effective antidysrhythmic drug for pharmacologic cardioversion of recent-onset atrial fibrillation ( AF ) .