Abstract

URIBE, William et al. Description of the clinical outcomes with an amiodarone modified dose for the conversion of acute atrial fibrillation to sinus rhythm. Rev. Colom. Cardiol. [online]. 2009, vol.16, n.5, pp.201-213. ISSN 0120-5633.

Introduction: atrial fibrillation is the most common sustained cardiac arrhythmia.  Amiodarone is an antiarrhythmic used for conversion to sinus rhythm.  A success rate of 45 to 85% in the first 24 hours is reported for the most commonly used dose.  However, there is no consensus as to the optimal dose for treatment of atrial fibrillation. Objetive:  to evaluate the efficacy of IV amiodarone during the first 72 hours for conversion to sinus rhythm in patients with acute episodes of atrial fibrillation using a modification of the recommended dose. Methods: descriptive and retrospective study of all patients presenting with acute atrial fibrillation between January 2000 and June 2006 managed with the proposed dose of IV amiodarone. Results: clinical records of 152 patients were evaluated.  Average age was 61.8 ± 16.9 years (SD).  63.2% of patients were male. The rate of conversion to sinus rhythm was 70.5%. Of these, 81.3% converted in the first 24 hours. Presence of dilated cardiomyopathy, occurrence of permanent atrial fibrillation and slow ventricular response were associated with treatment failure, OR 4.73, 11.5 and 10.22 respectively (p<0.05).  A structurally healthy heart was associated with successful conversion to sinus rhythm as a protective factor OR 0.28%; p=0.011. Conclusions: the proposed dose of amiodarone was shown to be effective for conversion to sinus rhythm and safe due to the low frequency of adverse side effects encountered. It was also shown to be cost-effective when compared to other antiarrythmic drugs available in our area and with electric cardioversion.

Keywords : fibrilación auricular; amiodarona; ritmo sinusal; cardioversión química; cardioversión eléctrica; atrial fibrillation; amiodarone; sinus rhythm; chemical; cardioversion; electric cardioversion.

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