- Paper Report
- Open Access
Amiodarone to prevent arterial fibrillation
- Richard Venn1
© Current Science Ltd 2000
- Published: 20 April 2000
- atrial fibrillation
AF affects 5% of people over 65 years old, and results in complications such as stroke and heart failure. Restoration of sinus rhythm reduces complications and controls symptoms, but AF recurs in 50% of treated patients within 3-6 months. Class I agents have been reported to increase mortality when used to treat AF, whereas amiodarone has been shown to be more efficacious than other anti-arrythmic agents. Consequently, this study compared amiodarone with sotalol or propafenone for preventing recurrence of AF.
. Prospective, non-blinded, randomised trial to receive amiodarone (201 patients) or sotalol/propafenone (101 patients received each drug).
. Recruited patients had had at least one episode of symptomatic AF documented electrocardiographically.
. Patients received anticoagulants if AF lasted more than 48 h, and electrical cardioversion was performed if required.
. Dose of amiodarone following loading period = 200 mg/day
. Minimum follow-up 1 year.
The probability of remaining in sinus rhythm at follow-up was 69% in patients receiving amiodarone and 39% in those receiving sotalol or propafenone (P < 0.001). Mortality and major morbidity was similar in the groups but strokes and intracranial haemorrhages were reduced in the amiodarone group (P= 0.01). Significantly, more patients discontinued medication in the sotalol and propafenone groups because of lack of effect, but there were no differences due to adverse events. Pulmonary and thyroid toxicity were seen in four and two patients receiving amiodarone respectively.