Document Detail

Effects of amiodarone and diltiazem on persistent atrial fibrillation conversion and recurrence rates: a randomized controlled study.
MedLine Citation:
PMID:  12843685     Owner:  NLM     Status:  MEDLINE    
PURPOSE: To assess the effects of amiodarone and diltiazem on atrial fibrillation (AF) induced atrial electrical remodeling and their clinical implications. METHODS: Persistent AF patients were randomly assigned to three treatment groups over a period from 6 weeks before to 6 weeks after internal cardioversion: group A (35 patients, oral diltiazem), group B (34 patients, oral amiodarone) and group C (37 patients, no antiarrhythmic drugs). Several electrophysiological parameters were assessed 5 min and 24 h after cardioversion. RESULTS: Compared with controls, group B patients had significantly higher conversion rates (83% vs. 100%, p = 0.041) and a higher probability to maintain sinus rhythm (p = 0.037). Patients of group B had longer fibrillatory cycle length intervals than patients of group A and C (180 +/- 18 ms vs. 161 +/- 17 ms vs. 164 +/- 19 ms, p = 0.001) and longer atrial effective refractory periods (211 +/- 22 ms vs. 198 +/- 16 ms vs. 194 +/- 17 ms, p = 0.003) as assessed 5 min after conversion. Post-conversion density of supraventricular ectopics was significantly lower in group B compared to groups A and C (p = 0.001). CONCLUSIONS: Oral amiodarone increases conversion rates, prolongs fibrillatory cycle length and atrial effective refractory period and preserves sinus rhythm after cardioversion in persistent AF patients by suppressing the atrial ectopics that trigger AF.
Emmanuel G Manios; Hercules E Mavrakis; Emmanuel M Kanoupakis; Eleftherios M Kallergis; Despina N Dermitzaki; Despina C Kambouraki; Panos E Vardas
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Cardiovascular drugs and therapy / sponsored by the International Society of Cardiovascular Pharmacotherapy     Volume:  17     ISSN:  0920-3206     ISO Abbreviation:  Cardiovasc Drugs Ther     Publication Date:  2003 Jan 
Date Detail:
Created Date:  2003-07-04     Completed Date:  2003-12-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8712220     Medline TA:  Cardiovasc Drugs Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  31-9     Citation Subset:  IM    
Department of Cardiology, University Hospital of Heraklion, Crete, Greece.
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MeSH Terms
Amiodarone / therapeutic use*
Anti-Arrhythmia Agents / therapeutic use*
Atrial Fibrillation / drug therapy,  prevention & control*,  therapy*
Calcium Channel Blockers / therapeutic use
Calcium Channels, L-Type / drug effects
Chronic Disease
Diltiazem / therapeutic use*
Electric Countershock*
Electrophysiologic Techniques, Cardiac
Middle Aged
Prospective Studies
Recurrence / prevention & control
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 0/Calcium Channel Blockers; 0/Calcium Channels, L-Type; 1951-25-3/Amiodarone; 42399-41-7/Diltiazem
Comment In:
Cardiovasc Drugs Ther. 2003 Jan;17(1):5-6   [PMID:  12916518 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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