Comparison of pharmacological and electrical cardioversion in permanent atrial fibrillation after prosthetic cardiac valve replacement: A prospective randomized trial
| Autor: | Zhi Yi Xu, Xin Qiang Guan, Kun Yang, Zhen Zhen Li, Yan Hua Zhang, Wen Sheng Chen, Wen Qin Chen, Bing Ren Gao |
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| Rok vydání: | 2013 |
| Předmět: |
Adult
Male Cardiac valve replacement Simvastatin medicine.medical_specialty Captopril Randomization Heart disease medicine.medical_treatment Amiodarone Anesthesia General Cardioversion Biochemistry law.invention Randomized controlled trial law Internal medicine Atrial Fibrillation medicine Humans Prospective Studies Heart valve business.industry Biochemistry (medical) Atrial fibrillation Cell Biology General Medicine Middle Aged medicine.disease Electric Stimulation Electrical cardioversion Treatment Outcome medicine.anatomical_structure Heart Valve Prosthesis Anesthesia Cardiology Mitral Valve Drug Therapy Combination Female business |
| Zdroj: | Journal of International Medical Research. 41:1067-1073 |
| ISSN: | 1473-2300 0300-0605 |
| Popis: | Objective To compare the efficacy of electrical versus pharmacological cardioversion following prosthetic cardiac valve replacement in patients with permanent atrial fibrillation (AF). Methods Patients with permanent AF who had undergone prosthetic cardiac valve replacement, who had a cardiothoracic ratio ≤0.5 and a left atrial diameter ≤50 mm for ≥6 months after surgery were randomly divided to receive either electrical or pharmacological cardioversion. Patients in the electrical cardioversion group were given direct-current synchronized electrical defibrillation under general anaesthesia. Patients in the pharmacological cardioversion group were given oral combination therapy with amiodarone, captopril and simvastatin for 3 months. Results A total of 115 patients received either electrical cardioversion ( n = 59) or pharmacological cardioversion ( n = 56); reversion to sinus rhythm occurred in 98.3% and 26.8%, respectively. Recurrence rates were similar in the two groups (3.4% and 6.7% for electrical and pharmacological cardioversion, respectively). No deaths or severe complications were reported. Conclusion Electrical cardioversion has a favourable safety profile and appears to be a more effective method than pharmacological cardioversion for the treatment of permanent AF after cardiac valve replacement, once the heart has returned close to its normal size. |
| Databáze: | OpenAIRE |
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