Cardiology Research, ISSN 1923-2829 print, 1923-2837 online, Open Access
Article copyright, the authors; Journal compilation copyright, Cardiol Res and Elmer Press Inc
Journal website https://www.cardiologyres.org

Short Communication

Volume 9, Number 3, June 2018, pages 165-170


Revisiting the Role of Antiarrhythmic Drugs in Prevention of Atrial Fibrillation Recurrence: A Single Center Retrospective Review

Tables

Table 1. Baseline Clinical Characteristics of the Patients
 
Baseline characteristicsTotal patient cohortSotalol groupAmiodarone groupPropafenone groupFlecainide group
Total patients14566 (45.52 %)65 (44.83%)12 (8.28%)2 (1.37 %)
Sex: female74(51.03%)31 (21.38%)31 (21.38%)11(7.59%)1 (0.68 %)
Mean age (years) ± SD77 ± 6.7372.45 ± 9.3381.03 ± 6.3267.44 ± 3.7765.5 ± 8.5
History of coronary artery disease89 (61.38%)47 (32.41%)39 (26.90%)3 (2.07%)0
History of moderate to severe valvular heart disease24 (16.55%)12 (8.28%)11 (7.59%)01 (0.68%)
Hypertension139 (95.86%)63 (43.45%)62 (42.75 %)12 (8.28%)2 (1.38%)
Diabetes mellitus26 (22.61%)14 (12.17%)10 (8.70%)2 (1.74%)0
Type of AF(paroxysmal versus persistent)Paroxysmal 134 (92.41%); Persistent 11(7.59%)Paroxysmal 61 (42.06%); Persistent 5(3.45%)Paroxysmal 59 (40.69%); Persistent 6 (4.14%)Paroxysmal 12 (8.28%); Persistent 0Paroxysmal 2 (1.38%); Persistent 0
Ejection fraction (%)56.72 ± 8.2156.69 ± 8.2957.17 ± 8.3758.63 ± 5.8054.5 ± 6.36

 

Table 2. Antiarrhythmic Drugs Used
 
Antiarrhythmic drugBasic criteria of initial choiceMain adverse effects monitored
LVEF: left ventricular ejection fraction; LFT: liver function test; CHF: congestive heart failure. Cardiac arrhythmias included but not limited to: QT prolongation, torsades, new or exacerbation of ventricular arrhythmias, atrioventricular block and bradycardia.
AmiodaroneAge > 75 years, age < 75 years with renal insufficiency, reduced LVEF, as an alternative to failed first choice agentArrhythmias, LFT derangement, pulmonary toxicity, skin reaction, thyroid dysfunction, hypotension
SotalolAge 65 - 75 years with normal renal function as first preference, as an alternative to failed first choice agentArrhythmias, bronchospasm, lupus like reaction, CHF, avoided in aortic stenosis due to LVH
PropafenoneAge < 65 yearsArrhythmias, CHF, myasthenia gravis exacerbation, agranulocytosis
FlecainideAge < 60 years as first preference in absence of structural heart diseaseArrhythmias, CHF

 

Table 3. Comparatively Showing Number of Patients and Mean Duration of First AF Recurrence
 
AF recurrenceSotalolAmiodaronePropafenoneFlecainideCombined class IC (propafenone + flecainide)Combined class III (amiodarone + sotalol)
Number of patients with recurrence (N)171331430
Mean duration of first AF recurrence ± SD (months)18 ± 14.8517.38 ± 9.9021.33 ± 22.8118.5 ± 020.63 ± 18.6817.69 ± 12.37

 

Table 4. Statistical Significance for Primary End Point Among AADs
 
Sotalol vs. amiodaroneSotalol vs. propafenoneSotalol vs. class ICAmiodarone vs. propafenoneAmiodarone vs. class ICClass III vs. class IC
NS: statistically not significant. P < 0.05 was considered statistically significant.
P-value for duration of first AF recurrence0.90 (NS)0.75 (NS)0.77 (NS)0.63 (NS)0.64 (NS)0.68 (NS)

 

Table 5. Different Average Daily Dose of AADs and Recurrence of AF
 
AADsRecurrence of AFNon-recurrence of AFP-value
Sotalol
  Number of patients1749
  Mean daily dose (mg): mean ± SD146.38 ± 30.04209.18 ± 83.54< 0.05
Amiodarone
  Number of patients1352
  Mean daily dose (mg): mean ± SD151.65 ± 87.71217.34 ± 66.85< 0.05
Propafenone
  Number of patients39
  Mean daily dose (mg): mean ± SD716.67 ± 115.47805.56 ± 88.19> 0.05