Atrial fibrillation: acute: oral amiodarone increases cardioversion

Clinical bottom line (level 1b)

  1. Patients with acute onset atrial fibrillation who took oral amiodarone compared with placebo were more likely to be in sinus rhythm (NN T = 2 at 24 hours) .
Peuhkurinen et al: American Journal of Cardiology 2000; 85 : 462-465
Expires November 2003

The study

Unblinded concealed randomised trial without intention-to-treat
Setting: 2 acute hospitals, Finland

72 patients (aged mean 59, 73% male) with acute atrial fibrillation (< 48 hours) lasting for at least 3 hours in hospital

Excluded if
  • thyroid disease
  • history of myocardial infarction
  • pulmonary oedema
  • sick sinus syndrome or high AV block
  • anaemia or hypovolaemia
  • stroke
  • sepsis
  • hepatic or renal disease
  • women of child-bearing potential
  • use of sotalol or other class III antiarrhythmic drugs
  • ventricular rate < 50, > 150 beats/min
  • haemodynamically unstable
  • abnormal serum potassium
  • aged < 18

    Control Group: (n = 36, 31 analysed): placebo
    Experimental Group: (n = 36, 31 analysed): amiodarone 30 mg /kg

    86% followed for 24 hours

    The evidence

    Outcome Time to outcome CER EER RRR
    (95% CI)    		 ARR
    (95% CI)    		 NN T
    (95% CI)
    cardioversion to sinus rhythm 24 hours 27
    (87.1%)    		 11
    (35.5%)    		 145%
    (50% to 300%)    		 51.6%
    (31.0% to 72.2%)    		 2
    (1 to 3)

    Comments

    1. No difference in adverse effects or median time to conversion was noted between the two groups.

    Citation

    1. Peuhkurinen K, Niemela M, Ylitalo A, et al: effectiveness of amiodarone as a single oral dose for recent-onset atrial fibrillation. American Journal of Cardiology 2000; 85 : 462-465
    Search Terms:
    Contributor: Chris Ball, November 2001
    Reviewer:

    Clinical Question.
    Patient acute atrial fibrillation
    Intervention or Exposure oral amiodarone
    Comparison placebo
    Outcome sinus rhythm
    		•