title: Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial.
abstract: BACKGROUND
  Atrial fibrillation is the most common sustained cardiac arrhythmia, and engenders significant health care costs. The impact of various treatment options for atrial fibrillation on hospital costs has not been evaluated in a randomized trial.
  
  
  METHODS
  We analysed 1-year follow-up data on 392 patients randomized to low dose amiodarone (200 mg. day(-1)) or alternative first-line therapy (sotalol or propafenone) in a multicentre trial (Canadian Trial of Atrial Fibrillation, CTAF).
  
  
  RESULTS
  Patients in the amiodarone group had fewer electrical cardioversions (65 vs 109 for patients in the sotalol/propafenone group, P<0.0001), and pacemaker insertions (4 vs 11, P=0.07). The average amiodarone patient spent fewer days in hospital (0.47 vs 0.97, P=0.01), and incurred lower costs ($532 vs $898, P=0.03), for admissions where atrial fibrillation was the admitting diagnosis. Average total hospital costs per patient for all admissions, as well as average combined hospital and physician costs per patient, showed wide variations within the treatment arms and were not significantly different between groups.
  
  
  CONCLUSIONS
  For patients in whom antiarrhythmic drug therapy is indicated, low dose amiodarone significantly reduces atrial fibrillation-related costs by reducing the number of atrial fibrillation-related procedures.
authors.affiliation: Research Center, Montreal, Quebec, Canada.
authors.forename: G B
authors.initials: GB
authors.lastname: Lumer
authors.forename: D
authors.initials: D
authors.lastname: Roy
authors.forename: M
authors.initials: M
authors.lastname: Talajic
authors.forename: A
authors.initials: A
authors.lastname: Couturier
authors.forename: J
authors.initials: J
authors.lastname: Lambert
authors.forename: N
authors.initials: N
authors.lastname: Frasure-Smith
authors.forename: B
authors.initials: B
authors.lastname: Thibault
authors.forename: M
authors.initials: M
authors.lastname: Dubuc
authors.forename: P
authors.initials: P
authors.lastname: Gagné
authors.forename: S
authors.initials: S
authors.lastname: Nattel
mesh_terms: D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D000704:Analysis of Variance; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000191:economics; D003365:Costs and Cost Analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011405:Propafenone / Q000627:therapeutic use; D013015:Sotalol / Q000627:therapeutic use
chemical_list: D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D013015:Sotalol; D000638:Amiodarone