Skip to main content

Atrial Fibrillation: Which Drug to Prefer for Acute Cardioversion?

  • Chapter
Cardiac Arrhythmias 1997
  • 86 Accesses

Abstract

The indisputed advantages of the pharmacological cardioversion of recent onset atrial fibrillation (good and at times high efficacy, action rapid and often during drug infusion, very good patient compliance, no need for hospitalization) have stimulated the interest of several authors to test both the efficacy of antiarrhythmic drugs and the possible preferential indications for each of them. In our opinion, there are three main factors that must be taken into consideration in choosing the kind of drug for atrial fibrillation (AF) cardioversion: 1) arrhythmia duration, 2) the clinical context in which it takes place, 3) ventricular function.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

eBook
USD 16.99
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Goy JJ, Gbric M, Hurni M, Finci L, Maendly R, Duc J, Sigwart U (1985) Conversion of supraventricular arrhythmias to sinus rhythm using flecainide. Eur Heart J 6: 518 – 524

    PubMed  CAS  Google Scholar 

  2. Borgeat A, Goy JJ, Maendly R, Kaufman U, Grbic M, Sigwart U (1986) Flecainide versus quinidine for conversion of atrial fibrillation to sinus rhythm. Am J Cardiol 58: 496 – 498

    Article  PubMed  CAS  Google Scholar 

  3. Suttorp MJ, Kingma JH, Jessuron ER, Lie-A-Huen L, Van Hemel LM, Lie KI (1990) The value of class 1C antiarrhythmic drugs for acute conversion of paroxysmal atrial fibrillation or flutter to sinus rhythm. J Am Coll Cardiol 16: 1722 – 1727

    Article  PubMed  CAS  Google Scholar 

  4. Donovan KD, Dobb GJ, Coombs LJ, Kok-Yeng Lee, Weekes JN, Murdock CJ, Clarche GM (1992) Efficacy of flecainide for the reversion of acute onset atrial fibrillation. Am J Cardiol 70: 50A – 55A

    Article  PubMed  CAS  Google Scholar 

  5. Baldi N, Lenti V, Marasco G, Russo VA, Montervino C (1992) Propafenone vs flecainide in the acute treatment of atrial fibrillation of recent onset: a randomized study. New Trends Arrhyth 8: 499 – 505

    Google Scholar 

  6. Capucci A, Gubelli S, Carini G, Frabetti L, Magnani B (1987) Cardioversione farmaco-logica con propafenone di fibrillazione atriale di recente insorgenza. G Ital Cardiol 17: 975 – 982

    PubMed  CAS  Google Scholar 

  7. Bianconi L, Boccadamo R, Pappalardo A, Gentili C, Pistoiese M (1989) Effectiveness of intravenous propafenone for conversion of atrial fibrillation and flutter of recent onset. Am J Cardiol 64: 335 – 338

    Article  PubMed  CAS  Google Scholar 

  8. Bertini G, Conti A, Fradella G, Francardelli L, Giglioli G, Mangialavori G, Margheri M, Moschi G (1990) Propafenone versus amiodarone in field treatment of primary atrial tachydysrhythmias. J Emerg Med 8: 15 – 20

    Article  PubMed  CAS  Google Scholar 

  9. Bracchetti D, Palmieri M (1992) Sicurezza ed efficacia del propafenone e.v. nella cardioversione della fibrillazione parossistica di recente insorgenza. G Ital Cardiol 23: 186 (abstr)

    Google Scholar 

  10. Gronda M, Occhetta E, Magnani A, Rognoni G, D’Aurelio M, Prandi MD, Rossi P (1982) Cardioversione del flutter e della fibrillazione atriale con amiodarone ad alte dosi. G Ital Cardiol 12: 628 – 634

    PubMed  CAS  Google Scholar 

  11. Faniel R, Shoenfeld Ph (1983) Efficacy of i.v. amiodarone in converting rapid atrial fibrillation and flutter to sinus rhythm in intensive care patients. Eur Heart J 4: 180 – 185

    PubMed  CAS  Google Scholar 

  12. Strasberg B, Arditti A, Sclarovsky S, Lewins RF, Buimovici B, Agmon J (1985) Efficacy of intravenous amiodarone in the management of paroxysmal or new atrial fibrillation with fast ventricular response. Int J Cardiol 7: 47 – 55

    Article  PubMed  CAS  Google Scholar 

  13. Cowan JC, Gardiner P, Reid DS, Newell DJ, Campbell RWF (1986) A comparison of amiodarone and digoxin in the treatment of atrial fibrillation complicating suspected acute myocardial infarction.J Cardiovasc Pharmacol 8: 252 – 256

    CAS  Google Scholar 

  14. Noc M, Stajer D, Horvat M (1990) Intravenous amiodarone versus verapamil for acute cardioversion of paroxysmal atrial fibrillation to sinus rhythm. Am J Cardiol 65: 679 – 680

    Article  PubMed  CAS  Google Scholar 

  15. Capucci A, Lenzi T, Boriani G, Trisolino G, Binetti N, Cavazza M, Fontana G, Magnani B (1992) Effectiveness of loading oral flecainide for converting recent-onset atrial fibrillation to sinus rhythm in patients without organic heart disease or with only systemic hypertension. Am J Cardiol 70: 69 – 72

    Article  PubMed  CAS  Google Scholar 

  16. Donovan KD, Power BM, Hockings BEF, Dobb GJ, Lee K-Y (1995) Intravenous flecainide versus amiodarone for recent-onset atrial fibrillation. Am J Cardiol 75: 693 – 697

    Article  PubMed  CAS  Google Scholar 

  17. Villani GQ, Rosi A, Piepoli M, Gandolfmi A, Groppi F, Groppi M, Arruzzoni S, Dieci G, Gazzola U (1990) Efficacia del trattamento orale con flecainide nella fibrillazione atriale parossistica: correlazione con le concentrazioni plasmatiche. G Ital Cardiol 20: 564 – 568

    PubMed  CAS  Google Scholar 

  18. Capucci A, Boriani G, Botto GL, Lenzi T, Rubino I, Falcone C, Trisolino G, Della Casa S, Binetti N, Cavazza M, Sanguinetti M, Magnani B (1994) Conversion of recent-onset atrial fibrillation by a single oral loading dose of propafenone or flecainide. Am J Cardiol 74: 503 – 505

    Article  PubMed  CAS  Google Scholar 

  19. Capucci A, FACC FESC on behalf of the SATE Group Investigators (1996) Propafenone as acute oral loading therapy in the conversion of recent onset atrial fibrillation is safe and effective. J Am Coll Cardiol 79A (abstr)

    Google Scholar 

  20. Boriani G, Capucci A, Botto GL, Rubino S, Lenzi T, Ongari M, Biffi M, Sabbatani P, Sanguinetti M, Magnani B (1996) Different pharmacologic treatment for converting recent-onset atrial fibrillation: evaluation on 377 patients. J Am Coll Cardiol 80A (abstr)

    Google Scholar 

  21. Crijns HJG, Van Wisk LM, Van Gilst WH, Kingma JH, Van Gelder IC, Lie KI (1988) Acute conversion of atrial fibrillation to sinus rhythm: clinical efficacy of flecainide acetate.Comparison of two regimens. Eur Heart J 9: 634 – 638

    PubMed  CAS  Google Scholar 

  22. Baldi N, Russo VA, Morrone V, Marasco G, Polimeni G, Conserva R, Tripaldi R, Angelini E (1995) Relation between plasma levels and efficacy of flecainide and propafenone, by a single oral loading dose, for treatment of atrial fibrillation of recent onset. New Trends Arrhyth 11: 251 – 256

    Google Scholar 

  23. Botto GL, Bonini W, Broffoni T, Falcone C, Mauri R, Molteni S, Tettamanti MG, Ferrari G (1994) Trattamento della fibrillazione atriale di recente insorgenza in pronto soccorso: confronto randomizzato, controllato con placebo tra il carico orale di propafenone o di digossina. G Ital Cardiol 24: 630 (abstr)

    Google Scholar 

  24. Klein GJ, Bashore TM, Sellers TD, Pritchett ELC, Smith WM, Gallagher JJ (1979) Ventricular fibrillation in the Wolff-Parkinson-White. N Engl J Med 301: 1080 – 1085

    Article  PubMed  CAS  Google Scholar 

  25. Wellens HJ, Durrer D (1973) Effect of digitalis on atrioventricular conduction and circus-movement tachycardias in patients with Wolff-Parkinson-White syndrome. Circulation 47: 1229 – 1233

    Article  PubMed  CAS  Google Scholar 

  26. Harper RW, Whitford E, Middlebrook K, Federman J, Anderson S, Pitt A (1982) Effect of verapamil on the electrophysiologic properties of the accessory pathway in patients with the Wolff-Parkinson-White syndrome. Am J Cardiol 50: 1323 - 1330

    Article  PubMed  CAS  Google Scholar 

  27. Michel B, Goy JJ, Kappenberger L (1989) Syndrome de Wolff-Parkinson-White et verapamil: à propos d’un cas de fibrillation auricolaire. Schweiz Med Wochenschr 13/119(19): 630 – 634

    Google Scholar 

  28. Vitale P, De Stefano R, Auricchio A (1986) Possibile pericolosità dell’amiodarone per via endovenosa rapida nel corso di tachicardia da rientro in soggetti con WolffParkinson-White. G Ital Cardiol 16: 969 – 974

    PubMed  CAS  Google Scholar 

  29. Neuss H, Buss J, Schlepper M, Berthold R, Mitrovic V, Kramer A, Musial WJ (1983) Effects of flecainide on electrophysiological properties of accessory pathways in the Wolff-Parkinson-White syndrome. Eur Heart J 4: 347 – 353

    PubMed  CAS  Google Scholar 

  30. Hellenstrand KJ, Nathan AW, Bexton RS, Camm AJ (1984) Electrophysiologic effects of flecainide acetate on sinus node function anomalous atrioventricular connections and pacemaker threshold. Am J Cardiol 53 (suppl B): 30 – 38

    Article  Google Scholar 

  31. Breithardt G, Borggrefe M, Wiebringhaus E, Seipel L (1984) Effect of propafenone in the Wolff-Parkinson-White syndrome: electrophysiological findings and long-term follow-up. Am J Cardiol 54: 29D – 39D

    Article  PubMed  CAS  Google Scholar 

  32. Kim SS, Lal R, Ruffy R (1986) Treatment of paroxysmal supraventricular tachycardia with flecainide acetate. Am J Cardiol 58: 80 – 85

    Article  PubMed  CAS  Google Scholar 

  33. Shen EN, Keung E, Huycke E, Dohrmann ML, Nguyenn N, Morady F, Sung RJ (1986) Intravenous propafenone for termination of reentrant supraventricular tachycardia. A placebo-controlled, randomized, double-blind, crossover study. Ann Intern Med 105: 655–659

    Google Scholar 

  34. Hammil SC, Mc Laran CJ, Wood DL, Osborne MJ, Gersh BJ, Holmes DR (1987) Double blind study of intravenous propafenone for paroxysmal supraventricular reentrant tachycardia. J Am Coll Cardiol 9: 1364 – 1368

    Article  Google Scholar 

  35. Ludmer PL, Mc Cowan NE, Antman EM, Friedman PL (1987) Efficacy of propafenone in Wolff-Parkinson-White syndrome: electrophysiologic findings and long-term follow-up. J Am Coll Cardiol 9: 1357 – 1363

    Article  PubMed  CAS  Google Scholar 

  36. Dubuc M, Kus T, Campa MA, Lambert C, Rosengarten M, Shenasa M (1989) Electrophysiologic effects of intravenous propafenone in Wolff-Parkinson-White syndrome. Am Heart J 117: 370 – 376

    Article  PubMed  CAS  Google Scholar 

  37. Kappenberger LJ, Fromer MA, Shenasa M, Gloor HO (1985) Evaluation of flecainide acetate in rapid atrial fibrillation complicating Wolff-Parkinson-White syndrome. Clin Cardiol 8: 321 – 326

    Article  PubMed  CAS  Google Scholar 

  38. Manolis AS, Salen DN, Estes NAM (1989) Electrophysiologic effects, efficacy and tolerance of class 1C antiarrhythmic agents in Wolff-Parkinson-White syndrome. Am J Cardiol 63: 746 – 750

    Article  PubMed  CAS  Google Scholar 

  39. Ogunkelu IB, Damato AN, Akthar M, Reddy CP, Caracta AR, Lau SH (1976) Electrophysiologic effects of procainamide in subtherapeutic dose on human atrio-ventricular conduction system. Am J Cardiol 37: 724 – 731

    Article  PubMed  CAS  Google Scholar 

  40. Hellenstrand KJ, Bexton RS, Nathan AW, Spurrel RA, Camm AJ (1982) Acute electrophysiological effects of flecainide acetate on cardiac conduction and refractoriness in man. Br Heart J 48: 140 – 148

    Article  Google Scholar 

  41. Pristowsky EN, Heger JJ, Chilson DA, Miles WM, Hubbard J, Zipes DP (1984) Antiarrhythmic and electrophysiologic effects of oral propafenone. Am J Cardiol 54: 26D – 28D

    Article  Google Scholar 

  42. Benaim R, Uzan C (1978) Les effets antiarrhithmiques de l’amiodarone injectable (à propos de 153 cas). Rev Med 19: 1959 – 1963

    Google Scholar 

  43. Morady F, Scheinman MM, Shen E, Shapiro W, Sung RJ, Di Carlo L (1983) Intravenous amiodarone in the acute treatment of recurrent symptomatic ventricular tachycardia. Am J Cardiol 51: 156 – 159

    Article  PubMed  CAS  Google Scholar 

  44. Horowitz LN, Spielma SR, Grenspan AM, Mintz GS, Morganroth J, Brown R, Brady PM, Kay HR (1985) Use of amiodarone in the treatment of persistent and paroxysmal atrial fibrillation resistant to quinidine therapy. J Am Coll Cardiol 6: 1402 – 1407

    Article  PubMed  CAS  Google Scholar 

  45. Blevins RD, Kerin NZ, Benaderet D, Frumin H, Faitel K, Jarandilla R, Rubenfire M (1987) Amiodarone in the management of refractory atrial fibrillation. Arch Intern Med 147: 1401 – 1404

    Article  PubMed  CAS  Google Scholar 

  46. Brodsky MA, Allen BJ, Walker III CJ, Casey TP, Luckett CR, Henry WL (1987) Amiodarone for maintenance of sinus rhythm after cardioversion of atrial fibrillation in the setting of a dilated left atrium. Am J Cardiol 60: 572 – 575

    Article  PubMed  CAS  Google Scholar 

  47. Gosselink ATM, Crijns HJGM, Van Gelder IC, Hillige H, Wiesfeld ACP, Lie KI (1992) Low-dose amiodarone for maintenance of sinus rhythm after cardioversion of atrial fibrillation or flutter. JAMA 267: 3289 – 3293

    Article  PubMed  CAS  Google Scholar 

  48. Skoulagiris J, Rothlisberger C, Skudicky D, Essop MR, Wisenbaught T, Sareli P (1993) Effectiveness of amiodarone and electrical cardioversion for chronic rheumathic atrial fibrillation after mitral valve surgery. Am J Cardiol 72: 423 – 427

    Article  Google Scholar 

  49. Pfisterer M, Burkart F, Muller-Brand J, Kiowski W (1985) Important differences between short and long-term hemodynamic effects of amiodarone in patients with chronic ischemic heart disease at rest and during ischemia-induced left ventricular dysfunction. J Am Coll Cardiol 5: 1205 – 1211

    Article  PubMed  CAS  Google Scholar 

  50. Sheldon RS, Mitchell LB, Duff HJ, Wyse DG, Manyar DE, Reynolds K (1988) Right and left ventricular function during chronic amiodarone therapy. Am J Cardiol 62: 736–740

    Google Scholar 

  51. Mostow ND, Vrobel TR, Noon D, Rakita L (1986) Rapid suppression of complex ventricular arrhythmias with high-dose oral amiodarone. Circulation 73: 1231 – 1238

    Article  PubMed  CAS  Google Scholar 

  52. Deedwania PC, Singh BN, Flechter R, Fisher S, Singh S (1996) Amiodarone improves survival by restoring and maintenance sinus rhythm in patients with chronic atrial fibrillation, dilated cardiomyopathy and congestive heart failure. Circulation 94 (suppl I): 667

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1998 Springer-Verlag Italia

About this chapter

Cite this chapter

Baldi, N., Russo, V.A., Morrone, V., Marasco, G., Polimeni, G. (1998). Atrial Fibrillation: Which Drug to Prefer for Acute Cardioversion?. In: Raviele, A. (eds) Cardiac Arrhythmias 1997. Springer, Milano. https://doi.org/10.1007/978-88-470-2288-1_5

Download citation

  • DOI: https://doi.org/10.1007/978-88-470-2288-1_5

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-88-470-2290-4

  • Online ISBN: 978-88-470-2288-1

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics