Abstract
The purpose of this study is to test the efficacy of bioactive natural product berberine in the treatment of patients with atrial fibrillation (AF). Data of 45 paroxysmal AF patients treated with berberine and 43 age, gender, New York Heart Association functional classification score, and concomitant cardiovascular disease matched patients treated with amiodarone were analyzed retrospectively to examine conversion rate, average conversion time, average heart rate, and echocardiographic parameters. There was no statistical difference between berberine and amiodarone on conversion rate or echocardiographic parameters. Berberine treatment showed a significantly longer average time to conversion and higher heart rate during sinus rhythm (SR) than amiodarone. Echocardiographic parameters showed that E/A ratio and left atrial diameter were significantly improved after 6- and 12-month berberine treatment, but only E/A ratio improved significantly at the same time points after amiodarone treatment. This is the first report to specifically compare efficacy of berberine and amiodarone in the treatment of patients with AF. We find that berberine and amiodarone are equally effective for conversion of AF and maintenance of normal SR.
Highlights
Bioactive natural products have been reported to exhibit antioxidant, antimicrobial, antiviral, anticancer, and antiinflammatory activities [1]
The purpose of this study was to test the efficacy of berberine in the treatment of patients with atrial fibrillation (AF) in comparison with amiodarone, a frequently prescribed and widely used Vaughn-Williams class III agent efficacious in converting AF to sinus rhythm (SR) [7, 8]
Baseline characteristics of the 88 patients followed to one year including age, gender, paroxysmal AF (PAF) history, smoking status, biochemical measurements, New York Heart Association (NYHA) Functional Classification, comorbidities, and concomitant therapies were summarized in Table 1; there was no significant difference between berberine and amiodarone groups
Summary
Bioactive natural products have been reported to exhibit antioxidant, antimicrobial, antiviral, anticancer, and antiinflammatory activities [1]. Originally used as an antimicrobial medication for the treatment of diarrhea [2], is a natural product isoquinoline alkaloid isolated from Chinese medicinal plant Coptis chinensis [3]. Later Dr Liu and Rao reported using berberine as an antiarrhythmic drug to treat 28 patients with ventricular premature beats in 1994 [6]. These early data showed potential for this agent as an antiarrhythmic with only minor gastrointestinal side effects but without comparing to other antiarrhythmics. The purpose of this study was to test the efficacy of berberine in the treatment of patients with atrial fibrillation (AF) in comparison with amiodarone, a frequently prescribed and widely used Vaughn-Williams class III agent efficacious in converting AF to sinus rhythm (SR) [7, 8]
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