title: [Adverse effects of antiarrhythmic drugs in patients with atrial fibrillation in primary care].
abstract: OBJECTIVE
  To determine the adverse effects (AE) of antiarrhythmic drugs used to treat atrial fibrillation (AF) in routine clinical practice.
  
  
  METHODS
  A retrospective, observational, population-based study of all patients diagnosed of AF requiring long-term treatment with antiarrhythmic drugs. We performed also a descriptive analysis of the type of EA, and their management (diagnostic techniques, laboratory tests, drug treatment, number of visits to health services, emergency visits, hospitalizations and surgeries).
  
  
  RESULTS
  We included 400 patients. Overall, 688 treatments were started, 34 of which (4.9%) were implied in 32 EA in 30 patients. The most frequent EA were hypothyroidism (28.1%), hyperthyroidism (25%) and bradycardia (9.38%). In absolute numbers, class III drugs (Vaughan-Williams classification) were associated with a higher number of AE (p=0.001). The number of AE/100 patients-year was: class I 0.42 (0.01-1.15%), class II 2.55 (0.68-5.13%), class III 4.70 (2.98-6.64%), class IV 1.18 (0.14-2.80%), digoxin 0.41 (0.08-1.19). Individually, the drugs with a higher rate were sotalol, bisoprolol and amiodarone (5.70, 5.37 and 4.59 respectively). 93.75% of EA required visits to health services, 59.38% laboratory tests and 56.25% diagnostic techniques. The most frequent visits were scheduled for primary care (75%), followed by scheduled visits to outpatient cardiology (21.9%). 71.9% of EA were resolved without any sequel and one patient died.
  
  
  CONCLUSIONS
  Antiarrhythmic drugs for the management of AF are associated with the presence of AE, mainly class III drugs. In most cases they are not serious, but imply important health resources.
authors.affiliation: «Grup transversal de recerca en Atenció Primària», IDIBAPS, Barcelona, España. mbs@comb.es
authors.forename: Luisa
authors.initials: L
authors.lastname: Benito
authors.forename: Jordi
authors.initials: J
authors.lastname: Hoyo
authors.forename: Angels
authors.initials: A
authors.lastname: Montroig
authors.forename: Berta
authors.initials: B
authors.lastname: Fornés
authors.forename: Guillem
authors.initials: G
authors.lastname: Fluxà
authors.forename: David
authors.initials: D
authors.lastname: Martí
authors.forename: Montserrat
authors.initials: M
authors.lastname: Pedrós
authors.forename: Antoni
authors.initials: A
authors.lastname: Sisó
authors.forename: Lluís
authors.initials: L
authors.lastname: Mont
authors.forename: Oscar
authors.initials: O
authors.lastname: Miró
authors.forename: Blanca
authors.initials: B
authors.lastname: Coll-Vinent
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects* / Q000145:classification / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy*; D001919:Bradycardia / Q000139:chemically induced* / Q000453:epidemiology; D015897:Comorbidity; D004487:Edema / Q000139:chemically induced / Q000453:epidemiology; D005260:Female; D005767:Gastrointestinal Diseases / Q000139:chemically induced / Q000453:epidemiology; D006801:Humans; D007037:Hypothyroidism / Q000139:chemically induced* / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011320:Primary Health Care / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D013030:Spain / Q000453:epidemiology
chemical_list: D000889:Anti-Arrhythmia Agents