atrial fibrillation, persistent
DISEASE INTERVENTION COMPARISON RESULTS
Circulation. 2002 Jul 16;106(3):331-6 Randomized Controlled Trial
IN atrial fibrillation, persistent The Use of
angiotensin II receptor blockers (irbesartan), added to amiodarone
As Treatment, Chronic
Is better Than
amiodarone alone
To reduce, at 9 months, recurrence of AF: 20% ibersartan plus VS 44% amiodarone alone
Mayo Clin Proc. 2009 Mar;84(3):234-42 Meta-Analysis
IN antiarrthythmic drugs, amiodarone, clinical use, adverse effects, atrial fibrillation, persistent, rhythm control strategy The Use of
amiodarone, low dose, 100 to 200 mg/d
As Treatment, Chronic
Is better Than
placebo
To restore and keep sinus rhythm (21.3% amiodarone vs 9.2% placebo at 1 year) but increase withdrawals by side effects (10.7% per year amiodarone vs 1.9% placebo)
Eur Heart J. 2003 Dec;24(23):2090-8 Randomized Controlled Trial
IN atrial fibrillation, persistent The Use of
angiotensin converting enzyme (ACE) inhibitors, enalapril, added to amiodarone
As Treatment, Chronic
Is better Than
amiodarone alone
To increase number of patients in SR at at 8 months: 84.3% enalapril VS 61.3% amiodarone alone
J Am Coll Cardiol. 2004 Apr 7;43(7):1201-8 Randomized Controlled Trial
IN atrial fibrillation, persistent The Use of
beta-blockers, but with frequent changes and combination needed
As Treatment, Chronic
Is better Than
calcium-channel blockers, diltiazem, digoxin
To adequately control heart rate: 70% beta-blockers, 54% calcium-channel blockers, 58% digoxin.
Heart. 2008 Feb;94(2):191-6. Epub 2007 May 4 Cohorts
IN atrial fibrillation, persistent The Use of
digitalis, digoxin
As Treatment, Chronic
Is worse Than
other rate control drugs
To modify mortality: 6.5% digitalis VS 4.1% non-digitalis, HR 1.53 after adjustement for other risk factors
Ann Intern Med. 1994 Mar 15;120(6):449-57 Decision Model
IN atrial fibrillation, persistent The Use of
rhythm control using amiodarone
As Treatment, Chronic
Is better Than
some other strategies: no treatment, warfarin alone, rhythm control using quinidine
To gain more quality-adjusted life-years: amiodarone obtained the best value (4.75 years), followed by warfarin (4.72 years), quinidine (4.68 years), and no treatment (4.55 years).
J Am Coll Cardiol. 2005 Mar 1;45(5):705-11 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, hypertension, primary The Use of
angiotensin II receptor blockers (losartan)
As Treatment, Chronic
Is better Than
beta-blockers
To reduce cardiovascular events (composite of cardiovascular mortality, stroke, and myocardial infarction): 36/171 patients with losartan VS 67/171 patients with B-blokers, at aprox 4 years
JAMA. 2005 Feb 9;293(6):690-8 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, non valvular, stroke, ischemic, cerebral infarction, embolic The Use of
anticoagulants, direct thrombin inhibitors, ximelagatran
As Treatment, Chronic
Is equal Than
warfarin
To prevent, at 20 months, stroke (of any type): 1.6% xime. VS 1.2% warf. Elevated liver enzymes (>3N): 6% xime. VS 0.8% warf. Major and minor bleeding combined fewer with xime. (37%) than warf. (47%) but not major bleeding alone.
N Engl J Med. 2006 Mar 2;354(9):934-41 Randomized Controlled Trial
IN atrial fibrillation, persistent, non-pharmacological treatment The Use of
catheter ablation, radiofrequency
As Treatment, Acute
Is better Than
cardioversion and chronic amiodarone
To reduce atrial fibrillation recurrence: 26% with ablation VS 42% amiodarone; and improve symptoms. Complications: atypical atrial flutter.
Circulation. 2004 Mar 30;109(12):1509-13 Cohorts
IN atrial fibrillation, persistent, rate control strategy The Use of
warfarin use, recovering and maintaining sinus rhythm (either reciving rate or rhythm control management)
As Prognostic Item
Is better Than
not receiving warfaring or resting in atrial fibrillation
To predict a reduced mortality. However, no association of the administration of rate or rhythm control or antiarrhythmics with changes in mortality.
Ann Intern Med. 2004 Nov 2;141(9):653-61 Cost-Effectiveness
IN atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is better Than
rhythm control strategy
To improve cost-effectiveness: rate control is always more effective and less costly
N Engl J Med. 2011 Dec 15;365(24):2268-76 Randomized Controlled Trial, Multicenter Study
IN atrial fibrillation, persistent, rate control, pharmacologic, Study ID: PALLAS 2011 The Use of
dronedarone
As Treatment, Chronic
Is worse Than
placebo
To modify cardiovascular events: dronedarone increased deaths from cardiovascular causes (HR 2.1), stroke (HR 2.3) and heart failure (HR 1.8)
Lancet. 2012 Jul 21;380(9838):238-46 Randomized Controlled Trial
IN atrial fibrillation, persistent, StudyID: Flec-SL 2012 The Use of
flecainide
As Treatment, Chronic
Is better Than
no treatment
To reduce recurrences of AF at 4 weeks: 52% flecainide VS 70% no Tt. It seems the control group was not continued afterwards
Circ J. 2009 Feb;73(2):242-8 Randomized Controlled Trial
IN Study ID: J-RHYTHM 2009, atrial fibrillation, persistent, rate control strategy The Use of
rate control strategy
As Treatment, Chronic
Is equal Than
rhythm control
To modify mortality and cardiovascular morbidity at 1.5 years
J Am Coll Cardiol. 2003 Jul 2;42(1):20-9 Randomized Controlled Trial
IN StudyID: AFFIRM Substudy 2003, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is better Than
sotalol, or a class I drug
To composite outcome (patients alive, in sinus rhythm, with no additional cardioversions and still taking the assigned drug) at 12 months: 60% amiodarone, 38% sotalol, 23% class I agents. Adverse effects were common.
Deutsche Medizinische Wochenschrift. 1978 Jun 30;103(26):1068-72 Randomized Controlled Trial
IN StudyID: Beck 1978, atrial fibrillation, persistent The Use of
propafenone
As Treatment, Acute
Is equal Than
lidoflazine
To acute conversion of AF
Arch Intern Med. 1987 Aug;147(8):1401-4 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Blevins 1987, atrial fibrillation, persistent, rejected The Use of
Amiodarone
As Treatment, Acute, Chronic
Is good Than
-
To AF recurrence, adverse effects, heart failure - at 16 Months
Am J Cardiol. 1987 Sep 1;60(7):572-5 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Brodsky 1987, atrial fibrillation, persistent, rejected The Use of
Amiodarone
As Treatment, Chronic
Is good Than
-
To AF recurrence, adverse effects, heart failure - at 12 Months
Eur Heart J. 2004 Jan;25(2):144-50 Randomized Controlled Trial
IN StudyID: Channer 2004, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects - at 12 months
Eur Heart J. 2003 Aug;24(16):1481-7 Randomized Controlled Trial
IN StudyID: DAFNE 2003, atrial fibrillation, persistent The Use of
dronedarone
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects, pro-arrhythmia - at 6 months
Congest Heart Fail. 2001 May-Jun;7(3):146-150 Randomized Controlled Trial, Multicenter Trial
IN StudyID: DIAMOND 2001 (subordinated publication), atrial fibrillation, persistent The Use of
dofetilide
As Treatment, Chronic
Is better Than
placebo
To mortality, FA recurrence, rehospitalization because heart failure, adverse effects, proarythmia - at 12 months
Ugeskr Laeger. 2000 Oct 30;162 (44);5948-53 Randomized Controlled Trial
IN StudyID: DIAMOND 2001 (subordinated publication), atrial fibrillation, persistent The Use of
dofetilide
As Treatment, Chronic
Is better Than
placebo
To mortality, FA recurrence, rehospitalization, heart failure - at 1 year
N Engl J Med. 1999 Sep 16;341(12):857-65 Randomized Controlled Trial, Multicenter Trial
IN StudyID: DIAMOND 2001 (subordinated publication), atrial fibrillation, persistent The Use of
dofetilide
As Treatment, Chronic
Is better Than
placebo
To mortality, FA recurrence, rehospitalization, heart failure - at 18 months
Circulation. 2001 Jul 17;104(3):292-6 Randomized Controlled Trial, Multicenter Trial
IN StudyID: DIAMOND 2001, atrial fibrillation, persistent The Use of
dofetilide
As Treatment, Chronic
Is better Than
placebo
To mortality, FA recurrence, rehospitalization, heart failure - at 12 months
Clin Cardiol. 2001 Mar;24(3):238-44 Descriptive
IN StudyID: Frick 2001, atrial fibrillation, persistent The Use of
elective electrical cardioversion
As Treatment, Acute
Is equal Than
no comparison here
To restore sinus rhythm in 75% patients. At 4 weeks only 37% of patients maintained sinus rhythm. Duration of AF < 3 months and right atrial dimension < 37 mm were independent predictors of maintaining SR
J Cardiovasc Pharmacol Ther. 2003 Sep;8(3):179-86 Clinical Trial (non-controlled, non-randomized)
IN StudyID: GEFACA 2001 (subordinated publication), atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is - Than
no comparison
To AF recurrence, adverse effects - at > 12 months
J Cardiovasc Pharmacol Ther. 2001 Oct;6(4):341-50 Randomized Controlled Trial, Multicenter Trial
IN StudyID: GEFACA 2001, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects - at average 9 months
Am J Cardiol. 1986 Jan 1;57(1):124-7 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Gold 1986, atrial fibrillation, persistent, rejected The Use of
Amiodarone
As Treatment, Chronic
Is good Than
-
To AF recurrence, adverse effects, heart failure - at ? Months
Am J Cardiol. 1988 Feb 15;61(6):473-4 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Hammil 1988, atrial fibrillation, persistent The Use of
propafenone
As unknow
Is - Than
unknow
To unknow
J Am Coll Cardiol. 1995 Oct;26(4):852-8 Randomized Controlled Trial
IN StudyID: Hohnloser 1995, atrial fibrillation, persistent The Use of
quinidine
As Treatment, Chronic
Is equal Than
sotalol
To AF recurrence, proarrhythmia, adverse effects - at 6 months
J Am Coll Cardiol. 1985 Dec;6(6):1402-7 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Horowitz 1985, atrial fibrillation, persistent, rejected The Use of
amiodarone
As Treatment, Chronic
Is good Than
-
To AF recurrence, adverse effects - at 15 months
Pol Arch Med Wewn. 1999 May;101(5):413-8 Randomized Controlled Trial
IN StudyID: HOT-CAFE 2004 (subordinated publication), atrial fibrillation, persistent The Use of
various antiarrhythmics
As Treatment, Chronic
Is equal Than
rate control
To mortality, stroke, heart failure, AF recurrence, adverse effects - at 1 year
Kardiol Pol. 2003 Jul;59(7):1-16; discussion 15-16 Randomized Controlled Trial
IN StudyID: HOT-CAFE 2004 (subordinated publication), atrial fibrillation, persistent The Use of
various antiarrhythmics
As Treatment, Chronic
Is equal Than
rate control
To mortality, stroke, heart failure, AF recurrence, adverse effects - at 1 year
Chest. 2004 Aug;126(2):476-86 Randomized Controlled Trial, Multicenter Trial
IN StudyID: HOT-CAFE 2004, atrial fibrillation, persistent The Use of
various AA
As Treatment, Chronic
Is worse Than
rate control
To mortality, stroke, heart failure, AF recurrence, adverse effects - at 1 year
Circ J. 2009 Jun;73(6):1020-7 Randomized Controlled Trial
IN StudyID: J-BAF 2009, atrial fibrillation, persistent The Use of
bepridil
As Treatment, Chronic
Is worse Than
placebo
To modify outcomes at 3 months: higher cardioversion to SR with bepridil but high recurrence of AF and significant pro-arrhythmia
Circulation. 1990 Dec;82(6):1932-9 Randomized Controlled Trial
IN StudyID: Juul-Moller 1990, atrial fibrillation, persistent The Use of
sotalol
As Treatment, Chronic
Is equal Than
quinidine
To AF recurrence, adverse effects - at 6 months
Z Kardiol. 1994;83(5):109-116 Randomized Controlled Trial
IN StudyID: Kalusche 1994, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is equal Than
quinidine + verapamil
To
Am J Cardiol. 2004 Sep 1;94(5):659-62 Randomized Controlled Trial
IN StudyID: Kanoupakis 2004, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is good Than
no comparison
To AF recurrence, adverse effects - at 4 weeks
Br Heart J. 1977;39(5):540-6 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Kenelly 1977, atrial fibrillation, persistent The Use of
lidoflazine
As Treatment, Chronic
Is worse Than
quinidine
To mortality: The trial was stopped after 4 patients died while receiving lidoflazine, probably by drug-induced arrhythmias
J Am Coll Cardiol. 2000 Jul;36(1):139-46 Randomized Controlled Trial
IN StudyID: Kuhlkamp 2000, atrial fibrillation, persistent The Use of
beta blockers, metoprolol
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects - at 6 months
Am J Cardiol. 2004 Jan 1;93(1):45-8 Randomized Controlled Trial?
IN StudyID: Li 2004, atrial fibrillation, persistent The Use of
diverse AAR
As Treatment, Chronic
Is equal Than
rate control drugs
To AF recurrence - at 1 month
Am Heart J. 2000 Sep;140(3):437-44 Randomized Controlled Trial
IN StudyID: Okishige 2000, atrial fibrillation, persistent The Use of
pilsicainide
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, mortality, adverse effects - at 12 and 24 months
Clin Cardiol. 1997 Apr;20(4):337-40 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Opolski 1997, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is good Than
no comparison
To AF recurrence, adverse effects - at 12 months
Z Kardiol 1999 Mar;88(3):195-207 Randomized Controlled Trial
IN StudyID: PAFAC (subordinated publication), atrial fibrillation, persistent The Use of
quinidine, sotalol
As Treatment, Chronic
Is - Than
placebo
To mortality, AF recurrence - at 12 months
Eur Heart J. 2004 Aug;25(16):1385-94 Randomized Controlled Trial
IN StudyID: PAFAC, atrial fibrillation, persistent The Use of
quinidine, sotalol
As Treatment, Chronic
Is better Than
placebo
To mortality, adverse effects, pro-arrhythmia, AF recurrence - at 12 months
Am J Cardiol. 1989 Jan 1;63(1):114-6 Clinical Trial (non-controlled, non-randomized)
IN StudyID: Porterfield 1989, atrial fibrillation, persistent The Use of
propafenone
As unknow
Is - Than
unknow
To unknow
Cardiovasc Drugs Ther. 1996 May;10(2):145-52 Randomized Controlled Trial
IN StudyID: PRODIS 1996, atrial fibrillation, persistent The Use of
propafenone
As Treatment, Chronic
Is better Than
disopyramide
To mortality, AFrecurrence, adverse effects, pro-arrhythmia - at 6 months
J Clin Epidemiol 2002 Apr;55(4):358-63 Case-Control
IN StudyID: Ruigomez 2002, atrial fibrillation, persistent The Use of
incidence
As -
Is useful Than
-
To incidence rate of chronic AF was 1.7 per 1,000 person-years, and increased markedly with age. The major risk factors were age, high BMI, excessive alcohol consumption, and prior cardiovascular comorbidity. 40% did not receive either warfarin or aspirin
N Engl J Med. 2005 May 5;352(18):1861-72 Randomized Controlled Trial
IN StudyID: Safe-T 2005, atrial fibrillation, persistent The Use of
amiodarone, sotalol
As Treatment, Chronic
Is better Than
placebo
To mortality, stroke, proarrhythmia, AF recurrence - at 12 months
Circulation. 2000 Nov 7;102(19):2385-90 Randomized Controlled Trial, Multicenter Trial
IN StudyID: SAFIRE 2000, atrial fibrillation, persistent The Use of
dofetilide
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, proarrhythmia - at 12 months
Am J Cardiol. 1991 Nov 1;68(11):1227-30 Randomized Controlled Trial, Multicenter Trial
IN StudyID: Singh 1991, atrial fibrillation, persistent The Use of
sotalol
As unknow
Is - Than
unknow
To unknow
Am J Cardiol. 1997 Feb 15;79(4):418-23 Randomized Controlled Trial, Multicenter Trial
IN StudyID: Stroobandt 1997, atrial fibrillation, persistent The Use of
propafenone
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects - at 6 months
Circulation (Supp) 1988;78(4):ii626 Randomized Controlled Trial
IN StudyID: Van Gelder 1989 (subordinated publication), atrial fibrillation, persistent The Use of
flecainide
As Treatment, Chronic
Is better Than
placebo
To not available
Am J Cardiol. 1989 Dec 1;64(19):1317-21 Randomized Controlled Trial
IN StudyID: Van Gelder 1989, atrial fibrillation, persistent The Use of
flecainide
As Treatment, Chronic
Is better Than
placebo
To AF recurrence, adverse effects, proarrhythmia - at ? time
Eur Heart J. 2003 Aug;24(15):1425-9 Randomized Controlled Trial, Multicenter Trial
IN StudyID: VERARAF 2003, atrial fibrillation, persistent The Use of
amiodarone, flecainide, verapamil
As Treatment, Chronic
Is equal Than
flecainide, verapamil addition to any of both
To AF recurrence - at 3? Month
Z Kardiol. 1994;83(Suppl 5):101-8 Randomized Controlled Trial
IN StudyID: Zehender 1992 (subordinated publication), atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Acute
Is equal Than
quinidine + verapamil
To acute conversion of chronic AF
J Am Coll Cardiol. 1992 Apr;19(5):1054-9 Randomized Controlled Trial
IN StudyID: Zehender 1992, atrial fibrillation, persistent The Use of
amiodarone
As Treatment, Chronic
Is equal Than
quinidine + verapamil
To acute conversion of chronic AF