Abstract
Objective
Pharmacologic cardioversion of atrial fibrillation (AF) is a reasonable mode of treatment
if the arrhythmia is of recent onset. Results concerning the response rates of different
drugs, respectively, in daily clinical practice and data with regard to the parameters
associated with successful cardioversion are not very prevalent.
Methods
Three-hundred seventy-six patients who were admitted to the emergency department with
acute AF and a duration of shorter than 48 hours were enrolled into the AF registry.
Results
The most effective drugs were flecainide and ibutilide (95% and 76%). Low response
rates were observed with amiodarone (36%) and the individual use of digoxin or diltiazem
(19% and 18%). Factors associated with a successful cardioversion were a lower blood
pressure on admission (P = .002), a shorter time interval between the onset of AF and admission to the ED
(P = .003), and adherence to treatment guidelines (P < .0001).
Conclusion
The use of flecainide and ibutilide is associated with a much higher rate of cardioversion
than other drugs we studied.
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Article Info
Publication History
Published online: May 03, 2010
Accepted:
December 15,
2009
Received in revised form:
December 14,
2009
Received:
July 28,
2009
Footnotes
☆The work was supported by a grant of the Karl Landsteiner Institute of ischemic heart disease and rhythmology in St Pölten, Austria.
Identification
Copyright
© 2011 Published by Elsevier Inc.
