Document Detail


Rate of conversion and recurrence after sotalol treatment in patients with direct current-refractory atrial fibrillation.
MedLine Citation:
PMID:  16506639     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: A number of patients with persistent atrial fibrillation (AF) will not have sinus rhythm (SR) restored by direct current (DC) cardioversion. HYPOTHESIS: In patients with DC-refractory AF, oral pretreatment with sotalol increases the success rate at DC cardioversion. METHODS: Consecutive patients with persistent AF, refractory at a first DC cardioversion, were prospectively included. A comparative group of patients with AF not refractory at DC cardioversion was studied. Oral sotalol treatment was started after unsuccessful DC cardioversion and given at least 7 days before renewed cardioversion. Four weeks after cardioversion, an electrocardiogram was performed. RESULTS: In all, 53 patients were enrolled in the study. Forty-three (81%) in the sotalol group regained sinus rhythm (SR): 10 (19%) of these converted pharmacologically and 33 (62%) after a second DC cardioversion; SR was never restored in 10 patients (19%). After 4 weeks, SR was maintained in 29 patients (67%). The comparative group included 132 patients and differed significantly from the DC-refractory patients only with regard to weight. After 4 weeks, SR was maintained by 50 patients (37%) in this group. CONCLUSIONS: In patients with persistent AF refractory to DC cardioversion, oral pretreatment with sotalol results in a high rate of SR restoration, either pharmacologically or by DC cardioversion. Maintenance of SR at 4 weeks is of sufficient clinical relevance to consider this treatment option in patients with AF refractory to DC cardioversion.
Authors:
Anna Nergärdh; Rolf Nordlander; Mats Frick
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinical cardiology     Volume:  29     ISSN:  0160-9289     ISO Abbreviation:  Clin Cardiol     Publication Date:  2006 Feb 
Date Detail:
Created Date:  2006-03-01     Completed Date:  2007-07-10     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7903272     Medline TA:  Clin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  56-60     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Karolinska Institute at Stockholm South Hospital, Stockholm, Sweden. anna.nergardh@sodersjukhuset.se
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MeSH Terms
Descriptor/Qualifier:
Aged
Anti-Arrhythmia Agents / administration & dosage,  adverse effects,  therapeutic use*
Atrial Fibrillation / drug therapy*,  physiopathology,  therapy
Case-Control Studies
Electric Countershock*
Female
Heart Rate / drug effects*
Humans
Male
Middle Aged
Premedication*
Prospective Studies
Recurrence
Sotalol / administration & dosage,  adverse effects,  therapeutic use*
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 3930-20-9/Sotalol

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