Amiodarone showed no significant difference in heart rate reduction compared to digoxin (MD -5.44, p=0.26) but resulted in a higher rate of conversion to sinus rhythm (63% vs 35%) in patients with atrial fibrillation and heart failure.
Meta-Analysis
Does amiodarone improve heart rate control and sinus rhythm conversion compared to digoxin in patients with atrial fibrillation and heart failure?
Amiodarone is more effective than digoxin for restoring sinus rhythm in AF patients with heart failure, but may be associated with higher all-cause mortality.
Mean Difference: -5.44 (95% CI -9.53–-1.34)
p-value: p=0.26
= 25%; p = 0.26). On the other hand, the statistical analysis showed that amiodarone had a better effect on the conversion to sinus rhythm than digoxin (63% versus 35%, respectively). Based on evidence from our meta-analysis, the clinical effect of amiodarone and digoxin in the emergency treatment of AF on heart rate control was unclear. However, amiodarone has a significant impact on the restoration of sinus rhythm compared with digoxin and can be considered the first-line drug regimen in conversion to sinus rhythm for AF patients with evidence of heart failure. However, the use of amiodarone and digoxin is complicated by adverse events and all-cause mortality.
Zaki et al. (2022) conducted a meta-analysis in Atrial fibrillation with evidence of heart failure. Amiodarone vs. Digoxin was evaluated on Reduction of heart rate (MD -5.44, 95% CI -9.53 to -1.34, p=0.26). Amiodarone showed no significant difference in heart rate reduction compared to digoxin (MD -5.44, p=0.26) but resulted in a higher rate of conversion to sinus rhythm (63% vs 35%) in patients with atrial fibrillation and heart failure.
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