What is the clinical evidence from this study?

Study design: RCT. Population: Supraventricular arrhythmias after cardiac surgery (n=30). Intervention: Amiodarone vs. Digoxin. Primary outcome: Remaining in atrial fibrillation at 24 h.

What does this research mean for the field?

Intravenous amiodarone is safe and at least as effective as digoxin for managing postoperative supraventricular arrhythmias, with 6.7% versus 20.0% of patients remaining in atrial fibrillation at 24 hours. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To compare the efficacy of amiodarone and digoxin in managing atrial fibrillation and flutter after cardiac surgery.

January 1, 1994European Journal of Cardio-Thoracic Surgery

A comparison of amiodarone and digoxin for treatment of supraventricular arrhythmias after cardiac surgery

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Key result

Intravenous amiodarone was safe and at least as effective as digoxin for managing postoperative arrhythmias, with 6.7% vs 20.0% of patients remaining in atrial fibrillation at 24 hours.

Why the study?

Does amiodarone improve heart rate control and rhythm conversion compared to digoxin in patients with postoperative atrial fibrillation or flutter?

Population

30 patients, previously in sinus rhythm, who developed sustained atrial fibrillation or flutter following…

Comparison

Amiodarone administered as an intravenous… vs Digoxin given as an intravenous loading dose…

Design

RCT, Prospective randomised trial

Follow-up

24 hours

Authors

ACAndrew CochraneThe University of Melbourne MSMark SiddinsCD-adapco (United Kingdom)FRF.L. RosenfeldtBaker Heart and Diabetes Institute

Discussion

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Implication

Supports IV amiodarone for postoperative AF; extends non-surgical efficacy data to cardiac surgery.

Key Points

To compare the efficacy of amiodarone and digoxin in managing atrial fibrillation and flutter after cardiac surgery.
Prospective randomized trial with 30 patients developing atrial fibrillation or flutter post cardiac surgery.
Amiodarone given as intravenous loading followed by continuous infusion; digoxin administered intravenously and then as oral maintenance.
Electrocardiographic and hemodynamic monitoring continued for 24 hours post-treatment.
Heart rate reduction observed in both groups within first 6 hours; amiodarone group from 146 to 89 bpm, digoxin group from 144 to 95 bpm.
At 24 hours, 1 of 15 patients remained in atrial fibrillation for amiodarone compared to 3 of 15 for digoxin.
No adverse reactions recorded in either treatment group.

Study Design

Type

RCT (n=30)

Randomization

Randomized

Structured PICO

Does amiodarone improve heart rate control and rhythm conversion compared to digoxin in patients with postoperative atrial fibrillation or flutter?

Population

30 patients, previously in sinus rhythm, who developed sustained atrial fibrillation or flutter following myocardial revascularisation, valve surgery or combined procedures.

Intervention

Amiodarone administered as an intravenous loading dose followed by a continuous infusion.

Comparator

Digoxin given as an intravenous loading dose followed by oral maintenance therapy.

Outcome

Reduction in heart rate and conversion to sinus rhythm at 24 hours.surrogate

Main Result

Absolute Event Rate: 6.7% vs 20%

Intravenous amiodarone is safe and at least as effective as digoxin for the initial management of supraventricular arrhythmias after cardiac surgery.

Cite This Study

Cochrane et al. (1994) conducted an RCT in Supraventricular arrhythmias after cardiac surgery (n=30). Amiodarone vs. Digoxin was evaluated on Remaining in atrial fibrillation at 24 h. Intravenous amiodarone was safe and at least as effective as digoxin for managing postoperative arrhythmias, with 6.7% vs 20.0% of patients remaining in atrial fibrillation at 24 hours.

synapsesocial.com/papers/6a144bb77753e742da59d1b2 https://doi.org/10.1016/1010-7940(94)90114-7

Topics

Atrial fibrillation Persistent AF management Anticoagulation in AF

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A comparison of amiodarone and digoxin for treatment of supraventricular arrhythmias after cardiac surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

Topics

A comparison of amiodarone and digoxin for treatment of supraventricular arrhythmias after cardiac surgery

Discussion

Member takes

Implication

Key Points

Study Design

Structured PICO

Main Result

Cite This Study

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Topics

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