PMID- 22469557
OWN - NLM
STAT- MEDLINE
DCOM- 20140207
LR  - 20230815
IS  - 1874-1754 (Electronic)
IS  - 0167-5273 (Linking)
VI  - 165
IP  - 2
DP  - 2013 May 10
TI  - Interventions for the treatment of atrial fibrillation: a systematic literature 
      review and meta-analysis.
PG  - 229-36
LID - S0167-5273(12)00275-6 [pii]
LID - 10.1016/j.ijcard.2012.03.070 [doi]
AB  - BACKGROUND: To perform a systematic review/meta-analysis evaluating the efficacy 
      and safety of anti-arrhythmic drugs (AADs) in the treatment of atrial 
      fibrillation (AF). METHODS: Database searches (accessed April 2009) were 
      conducted to identify randomised controlled trials (RCTs). Comparators of 
      interest included all AADs, rate/rhythm strategies or catheter ablation in 
      comparison with AADs. Primary AADs of interest were restricted to Class IC 
      (flecainide and propafenone) and Class III (amiodarone, dofetilide, dronedarone 
      and sotalol). Data were analysed on an intention-to-treat basis and meta-analysis 
      performed using the Peto odds ratio (OR)/fixed-effect model. RESULTS: 113 
      publications met inclusion criteria. Of these, 74 publications considered an AAD 
      of primary interest. The odds of AF recurrence were generally significantly lower 
      with all active treatments versus non-active control. Dronedarone was the only 
      AAD to show a (non-significant) trend towards reducing the odds of mortality with 
      a narrow CI (OR 0.85 [0.66, 1.09]). Withdrawals due to adverse events (AEs), 
      incidence of serious adverse events (SAEs) and treatment discontinuation were 
      increased following active treatment compared with control, with few significant 
      differences reported between active treatments. Data for other morbidity outcomes 
      such as cardiovascular mortality, hospitalizations or persistence/compliance and 
      health-related quality of life (HRQoL) were limited and meta-analyses were not 
      possible for these outcomes. CONCLUSION: The current meta-analysis confirms the 
      efficacy of AADs in preventing AF recurrence, although their use is associated 
      with a greater incidence of AEs and treatment discontinuation. Further RCTs are 
      required to establish the benefit of AADs in the management of both morbidity 
      outcomes and HRQoL.
CI  - Copyright (c) 2012 Elsevier Ireland Ltd. All rights reserved.
FAU - Sullivan, Sean D
AU  - Sullivan SD
AD  - University of Washington, Seattle, USA.
FAU - Orme, Michelle E
AU  - Orme ME
FAU - Morais, Edith
AU  - Morais E
FAU - Mitchell, Stephen A
AU  - Mitchell SA
LA  - eng
PT  - Journal Article
PT  - Meta-Analysis
PT  - Review
PT  - Systematic Review
DEP - 20120401
PL  - Netherlands
TA  - Int J Cardiol
JT  - International journal of cardiology
JID - 8200291
RN  - 0 (Anti-Arrhythmia Agents)
SB  - IM
MH  - Anti-Arrhythmia Agents/*therapeutic use
MH  - Atrial Fibrillation/*drug therapy/*mortality
MH  - Humans
MH  - Randomized Controlled Trials as Topic/methods
MH  - Secondary Prevention
MH  - Treatment Outcome
EDAT- 2012/04/04 06:00
MHDA- 2014/02/08 06:00
CRDT- 2012/04/04 06:00
PHST- 2011/03/23 00:00 [received]
PHST- 2012/01/30 00:00 [revised]
PHST- 2012/03/03 00:00 [accepted]
PHST- 2012/04/04 06:00 [entrez]
PHST- 2012/04/04 06:00 [pubmed]
PHST- 2014/02/08 06:00 [medline]
AID - S0167-5273(12)00275-6 [pii]
AID - 10.1016/j.ijcard.2012.03.070 [doi]
PST - ppublish
SO  - Int J Cardiol. 2013 May 10;165(2):229-36. doi: 10.1016/j.ijcard.2012.03.070. Epub 
      2012 Apr 1.