Atrial fibrillation management on prehospital and in-hospital phases, based on the principles of evidence-based medicine

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Abstract

Atrial fibrillation (AF) is the most common type of arrhythmia and is associated with an increased risk of stroke and systemic thromboembolism, heart failure, deterioration in quality of life. The antiarrhythmic drugs (AD) remain the main therapeutic approach in case of AF management, especially on prehospital phase despite the high efficiency of electrical cardioversion (ECV), nowadays. Still, many questions remain unsolved especially the efficacy, tolerability and safety of these drugs, taking into account that AF is not life-threatening. This article, according to the 2014 AHA/ACC/HRS guideline, deals with the modern pharmacological cardioversion of paroxysmal and/or persistent AF, where experts focus on the results of a placebo-controlled studies and meta-analyses using different AD, nowadays. We prove the high efficiency of class IC AD, immediate restoration of sinus rhythm after intravenous and/or oral AD administration, the absence of serious adverse events and the absence of requirement for hospital admission after AD application, and included AD in the recommendations 2014 - class I, level of evidence A, now.

About the authors

O. N Miller

Novosibirsk State Medical University

Email: miller.olga@list.ru
д-р мед. наук, проф. каф. неотложной терапии, эндокринологии и профпатологии ФПК и ППВ ГБОУ ВПО НГМУ 630091, Russian Federation, Novosibirsk, Krasnyi pr-t, d. 52

A. V Tarasov

State Research Center for Preventive Medicine of the Ministry of Health of the Russian Federation

канд. мед. наук, кардиолог-аритмолог, врач высшей категории, ст. науч. сотр. ФГБУ ГНИЦ ПМ 101990, Russian Federation, Moscow, Petroverigskii per., d. 10, str. 3

I. S Dik

Medical center "Avicenna" group of companies "Mother and child"

терапевт высшей категории, кардиолог первой категории, ЗАО Медицинский центр «Авиценна» 630004, Russian Federation, Novosibirsk, pr-t Dimitrova, d. 7

I. E Belyaeva

City Clinical Hospital №34

кардиолог высшей категории, ГБУЗ НСО ГКБ №34 630054, Russian Federation, Novosibirsk, ul. Titova, d. 18

References

  1. Руксин В.В. Краткое руководство по неотложной кардиологии. СПб: ИнформМед, 2010.
  2. Татарский Б.А., Баталов Р.Е., Попов С.В. Фибрилляция предсердий: патофизиологические подходы к выбору антиаритмической терапии. Томск: STT, 2013.
  3. Van Gelder I.C, Brugemann J, Crijns H.J. Current treatment recommendations in antiarrhythmic therapy. Drugs 1998; 55 (3): 331-46.
  4. Von Besser K, Mills A.M. Is discharge to home after emergency department cardioversion safe for the treatment of recent - onset atrial fibrillation? Ann Emerg Med 2011; 58: 517-20.
  5. Bjerkelund C.J, Orning O.M. The efficacy of anticoagulant therapy in preventing embolism related to D.C. electrical conversion of atrial fibrillation. Am J Cardiol 1969; 23: 208-16.
  6. Arnold A.Z, Mick M.J, Mazurek R.P et al. Role of prophylactic anticoagulation for direct current cardioversion in patients with atrial fibrillation or atrial flutter. J Am Coll Cardiol 1992; 19: 851-5.
  7. Fatkin D, Kuchar D.L, Thorburn C.W et al. Transesophageal echocardiography before and during direct current cardioversion of atrial fibrillation: evidence for 'atrial stunning' as a mechanism of thromboembolic complications. J Am Coll Cardiol 1994; 23: 307-16.
  8. Falcone R.A, Morady F, Armstrong W.F. Transesophageal echocardiographic evaluation of left atrial appendage function and spontaneous contrast formation after chemical or electrical cardioversion of atrial fibrillation. Am J Cardiol 1996; 78: 435-9.
  9. Bellotti P, Spirito P, Lupi G et al. Left atrial appendage function assessed by transesophageal echocardiography before and on the day after elective cardioversion for nonvalvular atrial fibrillation. Am J Cardiol 1998; 8: 1199-202.
  10. Harjai K, Mobarek S, Abi-Samra F et al. Mechanical dysfunction of the left atrium and the left atrial appendage following cardioversion of atrial fibrillation and its relation to total electrical energy used for cardioversion. Am J Cardiol 1998; 81: 1125-9.
  11. Sparks P.B, Jayaprakash S, Vohra J.K et al. Left atrial 'stunning' following radiofrequency catheter ablation of chronic atrial flutter. J Am Coll Cardiol 1998; 32: 468-75.
  12. Mitusch R, Garbe M, Schmucker G et al. Relation of left atrial appendage function to the duration and reversibility of nonvalvular atrial fibrillation. Am J Cardiol 1995; 75: 944-7.
  13. Manning W.J, Silverman D.I, Katz S.E et al. Temporal dependence of the return of atrial mechanical function on the mode of cardioversion of atrial fibrillation to sinus rhythm. Am J Cardiol 1995; 75: 624-6.
  14. Grimm R.A, Leung D.Y, Black I.W et al. Left atrial appendage 'stunning' after spontaneous conversion of atrial fibrillation demonstrated by transesophageal Doppler echocardiography. Am Heart J 1995; 1 (30): 174-6.
  15. Black I.W, Fatkin D, Sagar K.B et al. Exclusion of atrial thrombus by transesophageal echocardiography does not preclude embolism aftercardioversion of atrial fibrillation. A multicenter study. Circulation 1994; 89: 2509-13.
  16. Berger M, Schweitzer P. Timing of thromboembolic events after electrical cardioversion of atrial fibrillation or flutter: a retrospective analysis. Am J Cardiol 1998; 82: 1545-7.
  17. Collins L.J, Silverman D.I, Douglas P.S et al. Cardioversion of nonrheumatic atrial fibrillation. Reduced thromboembolic complications with 4 weeks of precardioversion anticoagulation are related to atrial thrombus resolution. Circulation 1995; 92: 160-3.
  18. Goette А, Honeycutt С, Langberg J.J. Electrical remodelling in atrial fibrillation. Circulation 1996; 94 (7): 2968-74.
  19. Sra J, Zaidi S.T, Krum D et al. Correlation of spontaneous and induced premature atrial complexes initiating atrial fibrillation in humans: electrophysiologic parameters for guiding therapy. J Cardiovasc Electrophysiol 2001; 12 (12): 1347-52.
  20. Van Gelder I.C, Brugemann J, Crijns H.J. Current treatment recommendations in antiarrhythmic therapy. Drugs 1998; 55 (3): 331-46.
  21. AHA/ACC/HRS Guideline for the management of patients with atrial fibrillation. Http://circ.ahajournals.org/content/early/ 2014/04/10/CIR.
  22. Сулимов В.В. Медикаментозное лечение нарушений ритма сердца. М.: ГЭОТАР-Медиа, 2011; с. 409-16.
  23. Khan I.A. Single oral loading dose of propafenonefor pharmacological cardioversion of recent onset atrial fibrillation. J Am Coll Cardiol 2001; 37:542-7.
  24. Boriani G, Martignani C, Biffi M et al. Oral loading with propafenone for oral conversion of recent - onset atrial fibrillation. A review of in - hospital treatment. Drugs 2002; 62: 415-23.
  25. Naccarelli G.V, Walbrette D.L, Khan M et al. Old and new antiarrhythmic drugs for converting and maintaining sinus rhythm in atrial fibrillation. Comparative efficacy and results of trials. Am J Cardiol 2003; 91 (Suppl.): 15D-26D.
  26. Rresco C, Proclemer A. Clinical challenge II. Management of recent onset atrial fibrillation. Eur Heart J 1996; 17 (Suppl. C): 41-7.
  27. Conti A, Del Taglia B, Mariannini Y et al. Management of patients with acute atrial fibrillation in the ED. Am J Emerg Med 2010; 28: 903-10.
  28. Kosior D.A, Kochanowski V, Scislo P et al. Efficacy and tolerability of oral propafenone versus quinidine in the treatment of recent onset atrial fibrillation. A randomized, prospective study. Cardiol J 2009; 16: 521-7.
  29. Balla I, Petrela E, Kondili A. Pharmacological conversion of recent atrial fibrillation: a randomized, placebo - controlled study of three antiarrhythmic drugs. Anadolu Kardiyol Derg 2011; 11 (7): 600-6.
  30. Sestito A, Molina E. Atrial fibrillation and the pharmacological treatment: the role of propafenone. Eur Rev Med Pharmacol Sci 2012; 16 (2): 242-53.
  31. Boriani G, Biffi M, Capucci A et al. Oral propafenone to convert recent - onset atrial fibrillation in patients with and without underlying heart disease. A randomized controlled trial. Ann Intern Med 1997; 126: 621-4.
  32. Capucci A, Villiani G, Aschieri D. Safety of oral propafenone in the convertion of recept - onset atrial fibrillation to sinus rhythm: a prospective parallel placebo - controlled multicentred study. Int J Cardiol 1999; 68: 187-96.
  33. Antonelli D, Darawsha A, Rimbrot S et al. Propafenone dose for emergency room conversion of paroxysmal atrial fibrillation. Harefuah 1999; 136 (11): 857-915.
  34. Khan I.A. Single oral loading dose of propafenone for pharmacological cardiover - sionofrecent - onsetatrial fibrillation. JACC 2001; 37: 542-7.
  35. Alboni P, Botto G.L, Baldi N et al. Outpatient treatment of recent - onset atrial fibrillation with the “pill - in - the - pocket” approach. N Engl J Med 2004; 351: 2384-91.
  36. Deneer V.H, Borgh M.B, Kingma J.H et al. Oral antiarrhythmic drugs in converting recent onset atrial fibrillation. Pharm World Sci 2004; 26 (2): 66-78.
  37. Bunin Y.А, Anfalova L. Efficacy of propafenone as single oral loading dose in pharmacology converting recent - onset atrial fibrillation and atrial flutter. Europace 2005; 7 (Suppl. 1): 121-2.
  38. Фомина И.Г., Таризманова А.И., Ветлужский А.В. и др. Пропафенон при восстановлении синусового ритма у больных с персистирующей формой фибрилляции предсердий. «ПРОМЕТЕЙ» - открытое, мультицентровое, пилотное исследование в Российской Федерации. Кардиоваскулярная терапия и профилактика. 2005; 4: 65-9.
  39. Boriani G, Capucci A, Lenzi T et al. Propafenone for conversion of recent - onset atrial fibrillation. A controlled comparison between oral loading dose and intravenous administration. Chest 1995; 108: 355-8.
  40. Botto G, Bonini W, Broffoni T et al. Randomized, crossover, controlled comparison of oral loading versus intravenous infusion of propafenone in recent - onset atrial fibrillation. Pacing Clin Electrophysiol 1998; 21: 2480-84.
  41. Bianconi L, Mennuni M. Comparison between propafenone and digoxin administered intravenously to patients with acute atrial fibrillation. PAFIT-3 Investigators. The Propafenone in Atrial Fibrillation Italian Trial. Am J Cardiol 1998; 82 (5): 584-8.
  42. Tieleman R.G, Gosselink A.T, Crijns H.J et al. Efficacy, safety, and determinants of conversion of atrial fibrillation and flutter with oral amiodarone. Am J Cardiol 1997; 79: 53-7.
  43. Alboni P, Botto G.L, Baldi N et al. Outpatient treatment of recent - onset atrial fibrillation with the “pill - in - the - pocket” approach. N Engl J Med 2004; 351: 2384-91.
  44. Zipes D.P. Management of cardiac arrhytmias: Parmacological, electrical and surgical techniques. In: E Braunwald (ed) Heart disease-5th edition. Philadelphia, 1997; p. 593-639.
  45. Feld G.K. Atrial fibrillation. Is there a safe and highly effective pharmacological treatment? Circulation 1990; 82: 2248-50.
  46. Leitch J.W, Klein G.J, Yee R et al. Prognostic value of electrophysiology testing in asymptomatic patients with Wolff - Parkinson - White pattern. Circulation 1990; 82: 1718-23.
  47. Vardas P.E, Kochiadakis G.E, Igoumenidis N.E et al. Amiodarone as a first - choice drug for restoring sinus rhythm in patients with atrial fibrillation: a randomized, controlled study. Chest 2000; 1 (17): 1538-45.
  48. Martinez-Marcos F.J, Garcia-Garmendia J.L, Ortega-Carpio A et al. Comparison of intravenous flecainide, propafenone, and amiodarone for conversion of acute atrial fibrillation to sinus rhythm. Am J Cardiol 2000; 86: 950-3.
  49. Chevalier P, Durand-Dubief A, Burri H et al. Amiodarone versus placebo and class IС drugs for cardioversion of recent - onset atrial fibrillation: a meta - analysis. J Am Coll Cardiol 2003; 41 (2): 255-62.
  50. Kochiadakis G.E, Igoumenidis N.E, Solomou M.C et al. Efficacy of amiodarone for the termination of persistent atrial fibrillation. Am J Cardiol 1999; 83: 58-61.
  51. Kochiadakis G.E, Igoumenidis N.E, Parthenakis F et al. Amiodarone versus propafenone for conversion of chronic atrial fibrillation: results of a randomized, controlled study. J Am Colt Cardiol 1999; 33: 966-71.
  52. Singh B.N, Singh S.N, Reda D.J et al. Amiodarone versus Sotalol for Atrial Fibrillation. N Engl J Med 2005; 352: 1861-72.
  53. Galperin J, Elizari M.V, Chiale P.A et al. Efficacy of amiodarone for the termination of chronic atrial fibrillation and maintenance of normal sinus rhythm: a prospective, multicenter, randomized, controlled, double blind trial. J Cardiovasc Pharmacol Ther 2001; 6: 341-50.
  54. Bertini G, Conti A, Fradella G et al. Propafenone versus amiodarone in field treatment of primary atrial tachydysrhythmias. J Emerg Med 1990; 8: 15-20.
  55. Kerin N.Z, Faitel K, Naini M. The efficacy of intravenous amiodarone for the conversion of chronic atrial fibrillation. Amiodarone vs. quinidine for conversion of atrial fibrillation. Arch Intern Med 1996; 156: 49-53.
  56. Юричева Ю.А., Соколов С.Ф., Голицын С.П. и др. Новый антиаритмический препарат III класса ниферидил как эффективное средство восстановления синусового ритма при персистирующей форме мерцательной аритмии. Вестн. аритмологии. 2012; 70: 32-43.
  57. Stoschitzky K, Stoschitzky G, Lercher P et al. Propafenone shows class Ic and class II antiarrhythmic effects. Europace 2016; 18 (4): 568-71.
  58. Halpern S.W, Ellroot G, Singh B.N, Mandel W.J. Efficacy of intravenous procainamid infusion in converting atrial fibrillation to sinus rhythm. Relation to left atrium size. Brit Heart J 1980; 44: 589-95.
  59. Fenster P.E, Comess K.A, Marsh A et al. Conversion of atrial fibrillation to sinus rhythm by acute intravenous procainamide infusion. Am Heart J 1983; 106: 501-4.
  60. Kochiadakis G.E, Igoumenidis N.E, Solomou M.C et al. Conversion of atrial fibrillation to sinus rhythm using acute intravenous procainamide infusion. Cardiovasc Drugs Ther 1998; 12: 75-81.
  61. Kochiadakis G.E, Igoumenidis N.E, Hamilos M.E et al. A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent - onsetatrial fibrillation. Am J Cardiol 2007; 99: 1721-25.
  62. Stiell I.G, Clement C.M, Symington C et al. Emergency department use of intravenous procainamide for patients with acute atrial fibrillation or flutter. Acad Emerg Med 2007; 14: 1158-64.
  63. Singh S, Saini R.K, Di Marco J et al. Efficacy and safety of sotalol in digitalized patients with chronic atrial fibrillation. The Sotalol Study Group. Am J Cardiol 1991; 68: 1227-30.
  64. Vos M.A, Golitsyn S.R, Stangl K et al. Superiority of ibutilide (a new class III agent) over DL-sotalol in converting atrial flutter and atrial fibrillation. The Ibutilide/Sotalol Comparator Study Group. Heart 1998; 79: 568-75.
  65. Hohnloser S.H, Van De Loo A, Baedeker F. Efficacy and proarrhythmic hazards of pharmacologic cardioversion of atrial fibrillation: prospective comparison of sotalol versus quinidine. J Am Coll Cardiol 1995; 26: 852-8.
  66. Halinen M.O, Huttunen M, Paakkinen S et al. Comparison of sotalol with digoxin - quinidine for conversion of acute atrial fibrillation to sinus rhythm (the Sotalol - Digoxin - Quinidine Trial). Am J Cardiol 1995; 76: 495-8.
  67. Noc M, Stajer D, Horvat M. Intravenous amiodarone versus verapamil for acute conversion of paroxysmal atrial fibrillation to sinus rhythm. Am J Cardiol 1990; 65: 679-80.
  68. Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebocontrolled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group. Eur Heart J 1997; 18: 649-54.
  69. Barroffio R, Tisi G, Guzzini F et al. A randomised study comparing digoxin and propafenone in the treatment of recent onset atrial fibrillation. Clin Drug Invest 1995; 9: 277-83.
  70. Hou Z.Y, Chang M.S, Chen C.Y et al. Acute treatment of recent - onset atrial fibrillation and flutter with a tailored dosing regimen of intravenous amiodarone. A randomized, digoxin - controlled study. Eur Heart J 1995; 16: 521-8.
  71. Jordaens L. Conversion of atrial fibrillation to sinus rhythm and rate control by digoxin in comparison to placebo. Eur Heart J 1997; 18: 643-8.
  72. ESC guidelines 2011 on management of cardiovascular disease during pregnancy. doi: 10.1093/eurheartj/ehr 218.
  73. Vahanian A, Baumgartner H, Bax J et al. Guidelines on the management of valvular heart disease: the Task Force on the Management of Valvular Heart Disease of the European Society of Cardiology. Eur Heart J 2007; 28: 230-68.
  74. ACC/AHA Guidelines for the management о patients with valvular heart disease JACC 1998; 32 (5): 1486-588.
  75. Schmitt J, Duray G, Gersh B.J, Hohnloser S.H. Atrial fibrillation in acute myocardial infarction: a systematic review of the incidence, clinical features and prognostic implications. Eur Heart J 2009; 30: 1038-45.
  76. Crystal E, Garfinkle M.S, Connolly S.S et al. Interventions for preventing post - operative atrial fibrillation in patients undergoing heart surgery. Cochrane Database Syst Rev 2004; 4: CD003611.
  77. Nemati M.H, Astaneh B. Amiodarone Versus Propafenone to Treat Atrial Fibrillation after Coronary Artery Bypass Grafting: A Randomized Double Blind Controlled Trial. Korean J Thorac Cardiovasc Surg 2016; 49 (3): 177-84.
  78. Prystowsky E.N. Inpatient versus outpatient initiation of antiarrhythmic drug therapy for patients with supraventricular tachycardia. Clin Ciol Clin Cardiol 1994; 17 (9 Suppl. 2): 117-10.

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