A review of clinical trials assessing the efficacy and safety of newer antiarrhythmic drugs in atrial fibrillation.
Clinical trials assessing the efficacy of anti- arrhythmic drugs for terminating atrial fibrillation have demonstrated that rate control drugs have little to no added efficacy compared to placebo; however, spontaneous conversion of recent-onset atrial fibrillation is common. Antiarrhythmic drugs such as oral dofetilide, oral bolus-flecainide and propafenone and intravenous ibutilide all have a role in terminating atrial fibrillation. Active comparator trials have demonstrated that amiodarone is more efficacious in maintaining sinus rhythm than propafenone and sotalol. Multiple trials have demonstrated the safety of amiodarone, sotalol, dofetilide and azimilide in a post-myocardial infarction population and amiodarone and dofetilide in a congestive heart failure population. Newer antiarrhythmic agents, some with novel mechanisms of action, will add to the pharmacologic armamentarium in treating atrial fibrillation.
Division of Cardiology and the Pennsylvania State Cardiovascular Center, Penn State University College of Medicine, Hershey, PA 17033, USA. gnaccarelli@psu.edu
Gerald V
GV
Naccarelli
Deborah L
DL
Wolbrette
Luna
L
Bhatta
Mazhar
M
Khan
John
J
Hynes
Soraya
S
Samii
Jerry
J
Luck
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000401:mortality; D002986:Clinical Trials as Topic; D005544:Forecasting; D006325:Heart Atria / Q000187:drug effects / Q000473:pathology; D006329:Heart Conduction System / Q000187:drug effects / Q000473:pathology; D006801:Humans; D017063:Outcome Assessment, Health Care; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents