2017 Sep;12(6):853-859. doi: 10.1007/s11739-016-1497-4. BJones
BMHockings
Although many patients with atrial fibrillation experience relief of symptoms with control of the heart rate, some patients require restoration of sinus rhythm. When the article failed to make concealment methods explicit and the author failed to provide adequate clarification, we assumed concealment was inadequate. GOlshansky
SJanuary
Deds.Montori
No randomized placebo-controlled studies have been done to determine if a single oral dose of amiodarone may work as effectively.POPULATION STUDIED: Patients older than 18 years were eligible … We measured agreement and resolved disagreement by consensus.The reviewers also identified duplicate or updated publications and contacted the authors to clarify uncertainty about originality of data. Mean time for conversion overall was 385 mins in group ibutilide and 495 mins in group amiodarone … et al.
For a study with a 33% control event rate, the highest possible RR is 3; for a control event rate of 80%, the highest possible RR is 1.25, even if the treatment event rate is 100%. HMaciejewicz
AKNanas
On the other hand, experimenting with a wide variety of thresholds runs the substantial risk for capitalizing on the play of chance and identifying apparent subgroup differences that do not really exist. The mean conversion time with amiodarone was reported to be ranging from 224 to 414 minutes, 4, 18, 19, 26 which was consistent with the median time to conversion of 410 minutes in our study. RLSegal
Methodological quality
GQPiepoli
Amiodarone rated 5.0/10 vs Dronedarone rated 6.3/10 in … Statistical analysis
Although it appears likely that amiodarone is safe when used in the short-term setting for the conversion of AF to sinus rhythm, one would require studies with more detailed exploration of AEs to provide a definitive conclusion.Our review has some limitations. The efficacy reported is 34-69% with the bolus only regimens, and 55-95% with the bolus followed by infusion regimens. It is similar in structure to amiodarone with the addition of a methylsufonamide group and absence of iodine moieties. EBMiller
BACKGROUND: Amiodarone, a class III antiarrhythmic agent, is effective in the conversion of AF to sinus rhythm. WBLevy
This difference allows more rapid metabolism and a lower likelihood of side effects. DJGuyatt
GCook
References 2. It is an iodinated compound but is metabolized by plasma and tissue esterases rather than the CYP3A4 system. MMinder
G
Duration of AF proved to be a source of heterogeneity, leading to 2 analyses. DVaziri
2003 Feb;87(2-3):121-8. doi: 10.1016/s0167-5273(02)00467-9.Cybulski J, Kułakowski P, Budaj A, Danielewicz H, Maciejewicz J, Kawka-Urbanek T, Ceremuzyński L.Clin Cardiol. Citations that 1 reviewer considered relevant were further assessed independently by 2 of us (L.M.L. SHKlingenheben
et al. RCT indicates randomized controlled trial.Relative risk for conversion to sinus rhythm. doi: 10.1016/s0167-5273(02)00477-1. TCMiller
GHRyan
TBoriani
Unable to load your collection due to an error HEMarketou
Egger
Intravenous amiodarone in treatment of recent-onset atrial fibrillation. BJones
COVID-19 is an emerging, rapidly evolving situation. Clinicians frequently pre-treat patients with amiodarone to increase the efficacy of electrical cardioversion for atrial fibrillation (AF). Efficacy of agents for pharmacologic conversion of atrial fibrillation and subsequent maintenance of sinus rhythm. We found one such review that addressed the efficacy and safety of different antiarrhythmic drugs compared with placebo, digoxin, or calcium channel blockers (CCBs) in conversion of nonpostoperative AF to sinus rhythm.We included studies that met the following criteria: (1) Patients had AF of any etiology and duration; (2) The intervention consisted of amiodarone compared with placebo, digoxin, CCB, or no treatment (control group); (3) The primary outcome consisted of conversion to sinus rhythm during a period of 4 weeks or less; and (4) The design consisted of randomized or quasi-randomized clinical trials.We included published and unpublished studies without language restriction.