European heart journal
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European heart journal · Jan 2000
Randomized Controlled Trial Clinical TrialOral amiodarone increases the efficacy of direct-current cardioversion in restoration of sinus rhythm in patients with chronic atrial fibrillation.
Direct current cardioversion of persistent atrial fibrillation is one of the most widely used and effective treatments for the restoration of sinus rhythm, but may be hampered by a low success rate and a high percentage of early recurrence. Pre-treatment with amiodarone or a glucose-insulin-potassium solution could improve the efficacy of electrical cardioversion by reversing the partially depolarized diastolic potential of the subsidiary pacemakers in atrial fibrillation. In a controlled randomized study, we assessed the effectiveness of electrical cardioversion in patients with persistent atrial fibrillation after pre-treatment with amiodarone or potassium infusion and the efficacy of amiodarone in maintaining sinus rhythm after electrical cardioversion. ⋯ Pre-treatment with low-dose oral amiodarone, compared with oral diltiazem or glucose-insulin-potassium treatments, induces a significantly high percentage of instances of spontaneous conversion, increases electrical cardioversion efficacy and reduces atrial fibrillation recurrence.