Maintenance of sinus rhythm after electrical cardioversion of persistent atrial fibrillation. Sotalol vs bisoprolol

Plewan, Andreas; Lehmann, Günter; Ndrepepa, Gjin; Schreieck, Jürgen; Alt, Eckhard; Schömig, Albert; Schmitt, Claus

doi:10.1053/euhj.2000.2546

Cited by 92 publications

(41 citation statements)

References 22 publications

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“…Various beta blockers have shown moderate but consistent efficacy to prevent AF recurrence or reduce the frequency of paroxysmal AF, comparable to conventional antiarrhythmic drugs. [583][584][585][586] One placebo-controlled study 583 of 394 patients with persistent AF found a lower risk of early recurrence after cardioversion and slower ventricular response with sustainedrelease metoprolol than placebo. 583 Two studies found atenolol 587 and bisoprolol 584 as effective as sotalol and better than placebo in reducing the frequency and duration of paroxysmal AF and in reducing the probability of relapse after cardioversion, but proarrhythmic events occurred more often during treatment with sotalol.…”

Section: Agents With Proven Efficacy To Maintain Sinus Rhythmmentioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Fuster¹,

Rydén²,

Cannom³

et al. 2006

Circulation

1,877

589

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Section: Agents With Proven Efficacy To Maintain Sinus Rhythmmentioning

confidence: 99%

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Fuster¹,

Rydén²,

Cannom³

et al. 2006

Circulation

1,877

589

View full text Add to dashboard Cite

“…Both showed a similar level of P-AF suppression. Plewan, et al 23) compared the suppression of P-AF recurrence in persistent AF patients who underwent electrical defibrillation, and demonstrated that bisoprolol administration had a similar effect to that of sotalol administration in terms of suppressing P-AF recurrence. Furthermore, they concluded that administration of bisoprolol was more effective than administration of sotalol because of the lower incidence of side effects observed in the patients treated with bisoprolol.…”

Section: Discussionmentioning

confidence: 99%

Antiarrhythmic Effect of Bisoprolol, a Highly Selective .BETA.1-Blocker, in Patients With Paroxysmal Atrial Fibrillation

et al. 2008

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SUMMARYIn the treatment of arrhythmia, β-blockers are mainly used to regulate the heart rate. However, β-blockers are also known as drugs with an antiarrhythmic effect due to the suppression of sympathetic activity. We evaluated the antiarrhythmic effects of a highly selective β 1 -blocker, bisoprolol, in patients with diurnal paroxysmal atrial fibrillation (P-AF).A total of 136 patients with symptomatic diurnal P-AF were enrolled. Patients were divided into a diurnal-specific P-AF group and a diurnal & nocturnal P-AF group, as well as into a bisoprolol single use group and a combined use group with an antiarrhythmic drug. The effects of bisoprolol were evaluated in 3 categories: subjective symptom improvement, quality of life (QOL) improvement, and elimination of P-AF episode in Holter electrocardiograms (ECGs). For patients with effective treatment, a long-term effect up to 24 months was evaluated.Five patients (3.7%) discontinued bisoprolol due to side effects. Following administration of bisoprolol, 109 patients (80%) experienced subjective symptom improvement, 103 patients (76%) experienced QOL improvement, and elimination of P-AF episodes in ECGs was observed in 84 patients (62%). The elimination rate of P-AF episodes in ECGs was higher in the diurnal P-AF group than in the diurnal & nocturnal P-AF group (P = 0.042). There was no significant difference between the bisoprolol single use group and the combined use group. A long-term suppressive effect by bisoprolol was observed in 70 of 83 patients (84%).The results demonstrate that bisoprolol has an antiarrhythmic effect against sympathetic diurnal P-AF, improving subjective symptoms and QOL and eliminating P-AF episodes in ECGs. (Int Heart J 2008; 49: 281-293)

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“…In addition, relatively few patients were treated with antidysrhythmics (Sotalol 15%, b-blocker 22% and verapamil 6%) which may account for the low proportion of patients in sinus rhythm at 1-month follow-up. Earlier studies have shown a tendency for an increase in the proportion of patients remaining in sinus rhythm after cardioversion when treated with b-blockers [15,16].…”

Section: Discussionmentioning

confidence: 99%

Duration of warfarin sodium therapy prior to electrical cardioversion of atrial fibrillation

Ryman

Frick

Frykman

et al. 2003

Journal of Internal Medicine

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Objectives. To evaluate the duration of anticoagulation treatment with warfarin sodium before elective DC-cardioversion and to identify clinical variables predicting short-term versus long-term waiting times. Design. Retrospective. Subjects. Patients with a known start date for warfarin sodium, a known duration of atrial fibrillation (AF) and who underwent DC-cardioversion were included. Main outcome measures. Duration of treatment with warfarin sodium prior to DC-cardioversion. Methods. The hospital records of 288 consecutive patients with AF scheduled for elective cardioversion at two hospitals in Stockholm were reviewed. Only patients with a known start date for warfarin sodium and known duration of AF were included in the study.Results. The median age was 70 (26-85) years and the duration of AF at time of cardioversion were 18 weeks (5-273) weeks. The median treatment duration prior to cardioversion with warfarin sodium was 12 weeks. Sinus rhythm was established in 224 (78%) patients of which 90 (40%) remained in sinus rhythm 1 month after cardioversion. In multivariate analysis, the only independent predictor of short waiting times for cardioversion (8 vs. 15 weeks) was if a cardiologist instituted the treatment with warfarin sodium (P < 0.001, 95% CI 5.0-9.0). Conclusion. The average waiting time from start of warfarin sodium treatment to elective cardioversion exceeds by far the recommended 3-4 weeks on therapeutic international normalized ratio (INR). In order to minimize the time period until cardioversion significant changes in the out-of-hospital care logistics has to be undertaken.

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Maintenance of sinus rhythm after electrical cardioversion of persistent atrial fibrillation. Sotalol vs bisoprolol

Abstract: This study demonstrates that sotalol (160 mg x day(-1)) and bisoprolol (5 mg x day(-1)) are equally effective in maintaining sinus rhythm. Because of the side effects of sotalol, bisoprolol seems to be advantageous for maintenance of sinus rhythm after cardioversion of atrial fibrillation.

Cited by 92 publications

References 22 publications

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation

Antiarrhythmic Effect of Bisoprolol, a Highly Selective .BETA.1-Blocker, in Patients With Paroxysmal Atrial Fibrillation

Duration of warfarin sodium therapy prior to electrical cardioversion of atrial fibrillation

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