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Amiodarone after unsuccessful direct-current cardioversion of persistent atrial fibrillation

Dariusz A Kosior1, Beata Wozakowska-Kapłon, Mariusz Jasik

  • 1I Katedra i Klinika Kardiologii, Akademia Medyczna, ul. Banacha 1 a, 02-097 Warszawa. dkosior@amwaw.edu.pl

Kardiologia Polska
|December 29, 2005
PubMed

Insights

Amiodarone pretreatment followed by repeat direct current cardioversion safely restores sinus rhythm in about 80.6% of persistent atrial fibrillation patients. Over 72.2% maintained sinus rhythm at 12 months on low-dose amiodarone.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Pharmacology

Background:

  • Persistent atrial fibrillation (AF) poses a significant challenge for rhythm control.
  • Direct current cardioversion (DCC) is a common treatment for AF, but success rates can be limited after initial attempts.
  • Amiodarone is an antiarrhythmic drug with a role in managing AF.

Purpose of the Study:

  • To evaluate the safety and effectiveness of amiodarone pretreatment before repeat direct current cardioversion (DCC) for persistent atrial fibrillation (AF).
  • To assess the long-term maintenance of sinus rhythm (SR) after successful DCC with amiodarone therapy.

Main Methods:

  • A study involving 67 patients with persistent AF after an unsuccessful DCC.
  • Patients received oral amiodarone loading (cumulative dose up to 12.0-16.0 g) as an outpatient procedure before repeat DCC.
  • Follow-up was conducted for 12 months, monitoring SR maintenance and adverse events.

Main Results:

  • Spontaneous conversion to sinus rhythm (SR) occurred in 19.2% of patients during amiodarone pretreatment.
  • Repeat DCC successfully restored SR in 76% of patients, leading to an overall restoration rate of approximately 80.6%.
  • At 12 months, 72.2% of patients maintained SR on a low daily maintenance dose of amiodarone (100-200 mg).

Conclusions:

  • Amiodarone pretreatment combined with repeat DCC is an effective strategy for restoring and maintaining sinus rhythm in persistent AF.
  • The procedure was found to be safe, with only minor complications reported.
  • Long-term maintenance of SR is achievable with low-dose amiodarone therapy post-cardioversion.
Abstract

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