What question did this study set out to answer?

To evaluate the efficacy and safety of early direct current cardioversion combined with short-duration amiodarone for maintaining sinus rhythm in patients with rheumatic mitral stenosis and long-standing atrial fibrillation following balloon mitral valvotomy.

March 2, 2016SHILAP Revista de lepidopterologíaOpen Access

Evaluation of early direct current cardioversion for maintenance of sinus rhythm in rheumatic atrial fibrillation following successful balloon mitral valvotomy

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Why the study?

Does early direct current cardioversion with short-duration oral amiodarone improve maintenance of sinus rhythm in patients with rheumatic mitral stenosis and long-standing atrial fibrillation following successful balloon mitral valvotomy?

Population

35 patients with rheumatic mitral stenosis and long-standing atrial fibrillation who underwent successful…

Comparison

Early direct current cardioversion and oral… vs Successful PBMV only.

Design

RCT, Prospective randomized study

Follow-up

mean 7.6 months

Authors

GSGautam SharmaAll India Institute of Medical Sciences Raipur RKRajendran KrishnanNational Institute of Research in Tuberculosis VBVijay BohraCommand Hospital

Discussion

Member takes

Implication

Supports early DCCV plus short amiodarone after BMV in rheumatic MS with AF; extends rhythm-control evidence to this population.

Key Points

To evaluate the efficacy and safety of early direct current cardioversion combined with short-duration amiodarone for maintaining sinus rhythm in patients with rheumatic mitral stenosis and long-standing atrial fibrillation following balloon mitral valvotomy.
Prospective randomized study enrolling 35 patients with rheumatic mitral stenosis and long-standing atrial fibrillation who underwent successful percutaneous balloon mitral valvotomy.
Patients were randomized to receive standard post-valvotomy management alone (Group 1, n = 20) or early direct current cardioversion alongside 6 weeks of oral amiodarone (Group 2, n = 15).
Primary outcome was sinus rhythm maintenance at 6 months; secondary outcomes included functional capacity, embolic events, drug toxicity, and mortality over a mean follow-up of 7.6 months.
At 7.6 months, 87% of patients in the cardioversion group maintained sinus rhythm compared to only 5% in the control group (rate difference 0.82, 95% CI 0.2 to 1.01; p = 0.001).
Patients undergoing valvotomy alone had a significantly elevated risk of remaining in atrial fibrillation compared to the cardioversion group (RR 7.1, 95% CI 1.95 to 25.9; p = 0.001).
Quality of life scores significantly favored the cardioversion group (p = 0.001), with no reported deaths, strokes, or adverse drug effects in either arm.

Structured PICO

Population

35 patients with rheumatic mitral stenosis (MS) and long-standing atrial fibrillation (AF) who underwent successful percutaneous balloon mitral valvotomy (PBMV).

Intervention

Early direct current cardioversion (DCCV) and oral Amiodarone for 6 weeks following successful PBMV.

Comparator

Successful PBMV only.

Outcome

Maintenance of sinus rhythm (SR) after 6 months.surrogate

Early direct current cardioversion combined with short-course amiodarone following successful balloon mitral valvotomy significantly improves long-term maintenance of sinus rhythm in patients with rheumatic mitral stenosis and atrial fibrillation.

Cite This Study

Sharma et al. (2016) studied this question.

synapsesocial.com/papers/69fa89bdaa3ec536f2512118 https://doi.org/10.1016/j.ihj.2015.11.013

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Evaluation of early direct current cardioversion for maintenance of sinus rhythm in rheumatic atrial fibrillation following successful balloon mitral valvotomy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Evaluation of early direct current cardioversion for maintenance of sinus rhythm in rheumatic atrial fibrillation following successful balloon mitral valvotomy

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

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