October 14, 2008JAMA
Continuous vs Episodic Prophylactic Treatment With Amiodarone for the Prevention of Atrial Fibrillation
Why the study?
Does episodic amiodarone treatment reduce a composite of amiodarone and underlying heart disease-related major events in ambulatory patients with recurrent symptomatic persistent atrial fibrillation compared to continuous amiodarone treatment?
Population
209 ambulatory patients with recurrent symptomatic persistent atrial fibrillation
Comparison
Episodic amiodarone treatment after electrical… vs Continuous amiodarone treatment after electrical…
Design
RCT, randomly assigned
Follow-up
median 2.1 years
Authors
Discussion
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Implication
Episodic amiodarone shows no reduction in major events versus continuous therapy; challenges intermittent dosing and reinforces continuous treatment in persistent AF.
Structured PICO
Does episodic amiodarone treatment reduce a composite of amiodarone and underlying heart disease-related major events in ambulatory patients with recurrent symptomatic persistent atrial fibrillation compared to continuous amiodarone treatment?
P
Population
209 ambulatory patients with recurrent symptomatic persistent atrial fibrillation
I
Intervention
Episodic amiodarone treatment (discontinued after a month of sinus rhythm and reinitiated if atrial fibrillation relapsed, 1 month peri-electrical cardioversion) after electrical cardioversion following amiodarone loading
C
Comparator
Continuous amiodarone treatment (maintained throughout) after electrical cardioversion following amiodarone loading
O
Outcome
Composite of amiodarone and underlying heart disease-related major eventscomposite
Episodic amiodarone treatment did not reduce major adverse events compared to continuous treatment but resulted in significantly higher rates of atrial fibrillation recurrence, all-cause mortality, and cardiovascular hospitalizations.
Cite This Study
Ahmed et al. (2008) studied this question.