What is the clinical evidence from this study?

Study design: RCT. Population: Postoperative paroxysmal atrial fibrillation (n=118). Intervention: Intravenous cibenzoline vs. Intravenous disopyramide 50 mg. Primary outcome: Termination of postoperative paroxysmal AF within 60 min (p=0.0291).

January 1, 2010Circulation JournalOpen Access

Prospective Comparative Study of Intravenous Cibenzoline and Disopyramide Therapy in the Treatment of Paroxysmal Atrial Fibrillation After Cardiovascular Surgery

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Key result

Intravenous cibenzoline significantly increased the termination rate of postoperative paroxysmal atrial fibrillation compared to intravenous disopyramide (47% vs 24%, p=0.0291).

Why the study?

Does intravenous cibenzoline improve the termination of postoperative paroxysmal atrial fibrillation compared to disopyramide in patients undergoing cardiovascular surgery?

Population

118 patients who had postoperative paroxysmal atrial fibrillation lasting ≥30 min after cardiovascular…

Comparison

Intravenous cibenzoline 70 mg infused over 5-10… vs Intravenous disopyramide 50 mg infused over 5-10…

Design

RCT, Randomized using the envelope method.

Follow-up

60 min

Authors

TKTakashi KomatsuIwate Medical University HTHideaki TachibanaShowa University YSYoshihiro SatohIwate Medical University

Discussion

Member takes

Implication

Supports preferring cibenzoline over disopyramide for terminating postoperative paroxysmal AF; extends RCT evidence guiding antiarrhythmic selection after cardiovascular surgery.

Study Design

Type

RCT (n=118)

Randomization

Envelope method

Multicenter

Structured PICO

Does intravenous cibenzoline improve the termination of postoperative paroxysmal atrial fibrillation compared to disopyramide in patients undergoing cardiovascular surgery?

Population

118 patients with normal or minimally impaired left ventricular function who developed paroxysmal atrial fibrillation lasting ≥30 minutes after cardiovascular surgery.

Intervention

Intravenous cibenzoline 70 mg infused over 5-10 min.

Comparator

Intravenous disopyramide 50 mg infused over 5-10 min.

Outcome

Restoration of sinus rhythm within 60 min after termination of iv infusion.surrogate

Main Result

Absolute Event Rate: 47% vs 24%

p-value: p=0.0291

Intravenous cibenzoline is significantly more effective than disopyramide for terminating postoperative paroxysmal atrial fibrillation in patients with preserved left ventricular function, particularly those pretreated with beta-blockers and with smaller left atrial dimensions.

Limitations

No placebo group was included in the prospective clinical study.
Possible overlooking of asymptomatic AF because ECG monitoring was not continued until discharge.
Serum electrolyte concentrations were not determined at the time of onset of postoperative paroxysmal AF.
Limited number of subjects, including only patients with normal or minimally impaired left ventricular function.
No placebo group included in the study.
May have overlooked asymptomatic AF because ECG monitoring was not continued until discharge.
Did not determine serum electrolyte concentrations at the time of onset of postoperative paroxysmal AF.
Limited number of subjects, especially including only patients with normal or minimally impaired left ventricular function.

Cite This Study

Komatsu et al. (2010) conducted an RCT in Postoperative paroxysmal atrial fibrillation (n=118). Intravenous cibenzoline vs. Intravenous disopyramide 50 mg was evaluated on Termination of postoperative paroxysmal AF within 60 min (p=0.0291). Intravenous cibenzoline significantly increased the termination rate of postoperative paroxysmal atrial fibrillation compared to intravenous disopyramide (47% vs 24%, p=0.0291).

synapsesocial.com/papers/6a778933de5e3adfbdf720df https://doi.org/10.1253/circj.cj-10-0023

Topics

Persistent AF management Atrial fibrillation Anticoagulation in AF AF ablation outcomes

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Implication

Supports preferring cibenzoline over disopyramide for terminating postoperative paroxysmal AF; extends RCT evidence guiding antiarrhythmic selection after cardiovascular surgery.

Prospective Comparative Study of Intravenous Cibenzoline and Disopyramide Therapy in the Treatment of Paroxysmal Atrial Fibrillation After Cardiovascular Surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Topics

Prospective Comparative Study of Intravenous Cibenzoline and Disopyramide Therapy in the Treatment of Paroxysmal Atrial Fibrillation After Cardiovascular Surgery

Discussion

Member takes

Implication

Study Design

Structured PICO

Main Result

Limitations

Cite This Study

Also Consider

Topics

Also Consider