ObjectiveTo systematically review the efficacy of irbesartan combined with amiodarone versus amiodarone alone for paroxysmal atrial fibrillation. MethodsWe electronically searched databases including PubMed, CENTRAL, EMbase, VIP, CNKI and WanFang Data to collect randomized controlled trials (RCTs) about irbesartan combined with amiodarone versus amiodarone alone in the treatment of paroxysmal atrial fibrillation from 2000 to 2014. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies. Then, meta-analysis was performed using RevMan 5.2 software. ResultsA total of nine studies involving 998 patients were included. The results of meta-analysis showed that:Compared with the amiodarone group, the left atrial diameter was smaller (MD=-1.49, 95% CI -1.82 to -1.15), and the maintenance rates of sinus rhythm were higher (OR=3.02, 95%CI 2.21 to 4.11) in the irbesartan plus amiodarone group after 12 months. ConclusionCurrent evidence indicates that the combination treatment of irbesartan and amiodarone for paroxysmal atrial fibrillation is better than amiodarone alone in delaying the enlargement of left atrial diameter, as well as the maintenance of sinus rhythm. Due to limited quantity and quality of the included studies, more high quality studies are needed to verify the above conclusion.
Objective To evaluate efficacy of amiodarone in the prevention of atrial fibrillation after coronary artery bypass grafting. Methods CBM (from January 1978 to August 2017), CNKI (from January 1987 to August 2017), VIP (from January 1989 to August 2017), Wanfang (from January 1998 to August 2017) and PubMed (from January 1989 to August 2017) databases were searched. The articles were selected based on the inclusion and exclusion criteria. Quality of articles was assessed by improved Jadad scale. Statistical analysis was performed using RevMan 5.3. Results There were 19 articles meeting inclusion criteria including 2 817 patients and all were randomized controlled trial (RCT). There were 16 articles with high quality and 3 articles with low quality by improved Jadad scale. Compared with the placebo, amiodarone had a significant effect on reducing the incidence of atrial fibrillation after coronary artery bypass grafting (RR=0.37, 95% CI 0.28 to 0.50, P<0.000 01) and different administration models and time of amiodarone had effect on the atrial fibrillation after aterial bypass grafting (P<0.05). Conclusion Compared with the placebo, amiodarone is effective in reducing the incidence of atrial fibrillation after coronary artery bypass grafting.
ObjectiveTo systematically evaluate the pharmacoeconomic value of radiofrequency ablation (RFA) versus amiodarone in the treatment of atrial fibrillation (AF), and to provide reference for treatment scheme selection, drug selection and the formulation of drug policy. MethodsWe searched databases including PubMed, The Cochrane Library, CNKI and CBM from 2000 to 2014 to collect pharmacoeconomic studies on RFA versus Amiodarone for treating AF. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. The cost-effectiveness of RFA and Amiodarone for AF was compared according to the cost, effectiveness, and incremental cost-effectiveness ratio (ICER). ResultsA total of three studies were included. The results of pharmacoeconomic evaluation showed that the ICERs for each study were $7 976 to $29 068, ￡7 763 to ￡27 745, and $59 194, respectively. According to country-specific willingness to pay thresholds, the ICER of each included study was acceptable. ConclusionCompared to Amiodarone, RFA is a cost-effective therapy for AF.
Objective To systematically review the effectiveness of amiodarone in treating repurfusion arrhythmia (RA) after thrombolytic therapy for acute myocardial infarction (AMI), so as to provide high quality evidence for formulating the rational thrombolytic therapy for AMI. Methods Randomized controlled trails (RCTs) on amiodarone in treating RA after thrombolytic therapy for AMI were electronically retrieved in PubMed, EMbase, The Cochrane Library (Issue 3, 2012), CBM, CNKI, VIP and WanFang Data from inception to January, 2013. According to the inclusion and exclusion criteria, two reviewers independently screened literature, extracted data, and assessed quality. Then RevMan 5.1 software was used for meta-analysis. Results A total of 5 RCTs involving 440 patients were included. The results of meta-analysis suggested that, compared with the blank control, amiodarone reduced the incidence of RA after thrombolytic therapy in treating AMI (RR=0.60, 95%CI 0.48 to 0.74, Plt;0.000 01) and the incidence of ventricular fibrillation (RR=0.47, 95%CI 0.26 to 0.85, P=0.01). It neither affected the recanalization rate of occluded arteries after thrombolytic therapy (RR=1.00, 95%CI 0.88 to 1.15, P=0.94) nor decreased the mortality after surgery (RR=0.33, 95%CI 0.10 to 1.09, P=0.07). Conclusion Current evidence indicated that, amiodarone can decrease the incidence of RA. Unfortunately, the mortality rate can’t be reduced by amiodarone. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion
ObjectiveTo investigate the effect of 5% dextrose intravenous infusion for phlebitis caused by amiodarone. MethodsA total of 136 patients treated in our hospital between June 2011 and March 2012 were randomly assigned into control group with 63 patients and intervention group with 73 patients. The control group was administrated 600 mg amiodarone with 15 drops/minute intravenous injection once daily, for 3 days, while for the intervention group patients, we added 5% dextrose solution infusion in the same channel at the same time. ResultsPhlebitis occurred in 22 patients (34.9%) in the control group, while the intervention group had only 11 (15.0%) (χ2=7.252,P=0.007). ConclusionInfusion of 5% dextrose solution can significantly reduce the occurrence of phlebitis caused by amiodarone.
ObjectiveTo systematically evaluate the efficacy and safety of radiofrequency ablation versus amiodarone in the treatment of atrial fibrillation, so as to provide reference for the chosen of clinical treatment options. MethodsWe searched PubMed, The Cochrane Library (Issue 10, 2014), CNKI, VIP and WanFang data from inception to October 2014 to collect randomized controlled trials (RCTs) comparing radiofrequency ablation versus amiodarone for atrial fibrillation. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed using RevMan 5.3 software. ResultsA total of 4 RCTs involving 511 atrial fibrillation patients were included. The results of meta-analysis showed that:compared with amiodarone, radiofrequency ablation could reduce the risk of atrial fibrillation recurrence (RR=0.35, 95%CI 0.22 to 0.55, P<0.000 01). There was no significant difference in all-cause mortality (RR=0.97, 95%CI 0.17 to 5.61, P=0.97) between both groups. The incidence of adverse events in the radiofrequency ablation group was 7.7%, and was lower than 12.7% of the amiodarone group, but there was no significant difference between the two groups. ConclusionCurrent evidence shows that, compared with amiodarona, radiofrequency ablation is related to lower recurrence rate and higher efficacy, but there is no difference in the safety between the two interventions. However, due to the limited quality and quantity of included studies, higher quality studies are needed to verify the above conclusion.
Objective To evaluate the therapeutic effectiveness and safety of ibutilide versus amiodarone in the treatment of atrial fibrillation and atrial flutter. Methods An electronic search in databases including PubMed, Embase, CNKI, WanFang Data, VIP Database, and The Cochrane Library (Issue 2, 2011), published from January 1994 to January 2011,was conducted to include both English and Chinese randomized controlled trials (RCTs) about ibutilide versus amiodarone in treating atrial fibrillation and atrial flutter. Two reviewers independently screened the studies according to the inclusive and exclusive criteria, extracted the data, assessed the methodological quality, and then performed Meta-analysis by using RevMan 5.0 software. Results Eight RCTs involving 506 patients were finally included. The results of Meta-analysis showed: a) The total effective rate of alleviating atrial fibrillation and atrial flutter in the ibutilide group was superior to that of the amiodarone group (OR=2.27, 95%CI 1.19 to 4.33, P=0.01); b) Four RCTs showed that ibutilide was similar to amiodarone for alleviating atrial fibrillation (OR=1.61, 95%CI 0.96 to 2.71, P=0.07), but the former was superior to the latter for alleviating atrial flutter (OR=8.97, 95%CI 4.51 to 17.84, Plt;0.000 01); c) Five RCTs showed that ibulitide took shorter time to alleviate atrial fibrillation and atrial flutter compared with amiodarone (WMD= –126.55 min, 95%CI –202.35 to –50.76, P=0.001); d) Four RCTs showed that the total adverse effect rates in the two groups had no significant difference (OR=1.13, 95%CI 0.37 to 3.43, P=0.83), but there were more cardiovascular side-effects in the ibutilide group (OR=2.36, 95%CI 1.40 to 4.01, P=0.001). Conclusion Compared with amiodarone, ibutilide has a higher total effective rate in cardioversion of atrial fibrillation and atrial flutter, and it obviously takes shorter time to alleviate atrial fibrillation and atrial flutter, but there is no significant difference in the cardioversion rate of atrial fibrillation between them. There is no significant difference in total side-effect rates between the two groups, but the cardiovascular adverse reaction in the ibutilide group is significantly higher than that of the amiodarone group. Because of the limited quantity and quality of the included studies, this conclusion has to be further proved by more high-quality RCTs.
目的:研究胺碘酮治疗心房颤动的疗效。方法:用胺碘酮治疗心房颤动患者68例(阵发性心房颤动40例,持续性心房颤动28例)。结果:连续用药治疗6个月显示治疗有效率分别为925%、75%。治疗12个月有效率分别为853%、68%。结论:胺碘酮治疗心房颤动安全有效,副作用小,可作为首选药。