Serial antiarrhythmic drug treatment to maintain sinus rhythm after electrical cardioversion for chronic atrial fibrillation or atrial flutter

Crijns, H. J. G. M.; VanGelder, IC; Vangilst, Wh; Hillege, Hans L.; Gosselink, A T Marcel; Lie, Ki

doi:10.1016/0002-9149(91)90828-9

Cited by 250 publications

(85 citation statements)

References 30 publications

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“…Eighty-nine of these patients participated in a study described previously. 1 Criteria for prophylactic treatment with amiodarone were also described previously by Crijns et al 2 In short, amiodarone was administered only as a ''last resort'' drug in patients who failed to maintain sinus rhythm after previous cardioversions despite serial antiarrhythmic drug From the Departments of Cardiology and Pharmacology, University Hospital Groningen, Groningen, The Netherlands. Manuscript received April 4, 1996; revised manuscript received and accepted July 15, 1996. Address for reprints: Harry J.G.M.…”

Section: Methodsmentioning

confidence: 99%

Efficacy, Safety, and Determinants of Conversion of Atrial Fibrillation and Flutter With Oral Amiodarone

Tieleman¹,

Gosselink²,

Crijns³

et al. 1997

The American Journal of Cardiology

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107

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Section: Methodsmentioning

confidence: 99%

Efficacy, Safety, and Determinants of Conversion of Atrial Fibrillation and Flutter With Oral Amiodarone

Tieleman¹,

Gosselink²,

Crijns³

et al. 1997

The American Journal of Cardiology

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107

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“…Because of the low efficacy of antiarrhythmic drugs [4][5][6] , ablation was largely used in the past decade and has been consolidated as an effective and safe treatment alternative [7][8][9][10][11][12][13] . However, ablation involves extensive manipulation of the left atrium, and, thus, aggressive anticoagulation with heparin during the intervention has proved to be fundamental [14][15][16] .…”

Section: Introductionmentioning

confidence: 99%

Segurança da ablação de fibrilação atrial com RNI terapêutico: comparação com a transição com heparina de baixo peso

Saad¹,

Costa²,

Costa³

et al. 2011

Arq. Bras. Cardiol.

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“…This seems excessive and inconsistent with observations of prior studies. 9,12 Since the investigators of the current study do not describe the criteria used for adverse event characterization, it can be speculated that they may have overestimated the problem. These investigators also found association between AF progression and the presence of co-morbidities.…”

mentioning

confidence: 96%

“…Such dichotomous nature of AF progression as observed in this study seems unique and inconsistent with prior reports. [5][6][7]9 There are several possible explanations for the discrepancy: prior studies were largely retrospective with variable patient follow-up, current study design may have overestimated certain AF categories, 5-year prospective follow-up while long may still be insufficient to truly gauge the natural history of AF in a heterogeneous population, etc.…”

mentioning

confidence: 99%

Review on "Atrial Fibrillation Progression: New Insight in The Natural History of This Arrhythmia"

Dixit¹

2009

J.A.F.I.B

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The past decade has witnessed a dramatic shift in our approach to the management of atrial fibrillation (AF).1 This can largely be attributed to the advent of catheter ablation therapy which has proven to be significantly more efficacious in achieving arrhythmia control than antiarrhythmic drugs. [2][3][4] However, despite these developments, there is paucity of data on the natural history of this arrhythmia and studies that have been conducted so far to evaluate this aspect of AF behavior, are mostly retrospective.5-7 Thus, there is a growing need to assess AF progression on a prospective basis.In response to this emerging need, Pappone et al report on the natural history of arrhythmia progression in a heterogeneous population of patients presenting with the first episode of AF that were prospectively followed for 5 years.8 Although this was an observational study, the prospective design ensured exclusion of subjects where AF was attributable to a reversible etiology. Thus over a 6 month period, 402 patients were screened of which, 106 were selected for participation. For the next 5-years, enrolled subjects were followed by multiple clinic visits, holter monitors and transthoracic echocardiograms (at 1, 3, 6 months and then annually) as well as trans-telephonic monitors which the patients were required to transmit from 5 days a week for the study duration. Additionally, all patients underwent transesophageal echocardiogram (TEE) at baseline and these were repeated annually in the subgroup of patients who had comorbidities.The initial AF episode was not treated in any consistent way. However, for subsequent recurrences, antiarrhythmic drug (AAD) therapy was initiated with class IC and / or class III agents. Patients that failed and / or were intolerant to AADs were offered catheter ablation. The primary study end-point was assessment of long-term AF progression. Thus over the 5-year follow-up period, almost half the patients (n=50) maintained sinus rhythm without any intervention. In the remaining 56 subjects that experienced AF recurrence, 11 patients were treated with catheter ablation and the rest (45 subjects) with AADs. In the latter group, AF remained paroxysmal in 21 and became persistent in 24 (16 of these progressed to a permanent stage). Patients demonstrating AF recurrence and / or AF progression were older and had more co-morbidities especially diabetes and heart failure. Other interesting observations included 19% incidence of silent AF and occurrence of cardiovascular / cerebrovascular events exclusively in patients with more established forms of AF.

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Serial antiarrhythmic drug treatment to maintain sinus rhythm after electrical cardioversion for chronic atrial fibrillation or atrial flutter

Cited by 250 publications

References 30 publications

Efficacy, Safety, and Determinants of Conversion of Atrial Fibrillation and Flutter With Oral Amiodarone

Efficacy, Safety, and Determinants of Conversion of Atrial Fibrillation and Flutter With Oral Amiodarone

Segurança da ablação de fibrilação atrial com RNI terapêutico: comparação com a transição com heparina de baixo peso

Review on "Atrial Fibrillation Progression: New Insight in The Natural History of This Arrhythmia"

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