Abstract

Aim. We aimed to compare effectiveness of new class III antiarrhythmic drug Refralon with direct current cardioversion (DCC) in patients with persistent atrial fibrillation (AF). Material and methods. 60 patients with persistent AF were randomized to groups of DCC (n=30) and pharmacologic conversion (PCV; n=30). There were no differences in age, sex, AF duration, concomitant cardiovascular diseases, CHA2DS2-VASc score and echocardiographic parameters between the groups compared. Initial assessment excluded contraindications to restore sinus rhythm (SR). In DCC group two attempts using biphasic synchronized shocks of 150 J and 170 J were performed. In PCV group patients received up to three subsequent intravenous injections of Refralon 10 μg/kg (maximal dose 30 μg/kg). Results. SR was restored in 27 of 30 patients (90%) in DCC group and in 28 of 30 patients (93.3%) in PCV group. 95% confidence interval (CI) for primary effectiveness criterion was [-0.1 – 0.16]. AF recurred in 1 patient after successful DCC. There were no AF recurrences in PCV group. 26 of 30 patients (86.7%) in DCC group and 28 of 30 patients (93.3%) in PCV group remained in SR 24 hours after cardioversion. 95%CI for secondary effectiveness criterion was [-0.07 – 0.19]. Conclusion. Effectiveness of Refralon is noninferior to DCC in patients with persistent AF.

Highlights

  • Material and methods. 60 patients with persistent atrial fibrillation (AF) were randomized to groups of direct current cardioversion (DCC) (n=30) and pharmacologic conversion (PCV; n=30)

  • sinus rhythm (SR) was restored in 27 of 30 patients (90%) in DCC group and in 28 of 30 patients (93.3%) in PCV group. 95% confidence interval (CI) for primary effectiveness criterion was [-0.1 – 0.16]

  • There were no AF recurrences in PCV group. 26 of 30 patients (86.7%) in DCC group and 28 of 30 patients (93.3%) in PCV group remained in SR 24 hours after cardioversion. 95%CI for secondary effectiveness criterion was [-0.07 – 0.19]

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Summary

Национальный медицинский исследовательский центр кардиологии

60 больных с персистирующей формой ФП были рандомизированы в группы электрической (ЭКВ; n=30) и медикаментозной кардиоверсии (МКВ; n=30). Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. Aim. We aimed to compare effectiveness of new class III antiarrhythmic drug Refralon with direct current cardioversion (DCC) in patients with persistent atrial fibrillation (AF). 60 patients with persistent AF were randomized to groups of DCC (n=30) and pharmacologic conversion (PCV; n=30). For citation: Mironov N.Y., Vlodzyanovskiy V.V., Yuricheva Y.A., Sokolov S.F., Golitsyn S.P., Rosenstraukh L.V., Chazov E.I. Safety and Effectiveness of Electrical and Pharmacological Cardioversion in Persistent Atrial Fibrillation. В настоящее время существуют 2 способа восстановления синусового ритма (СР) у больных фибрилляцией предсердий (ФП) – электрическая (ЭКВ) и медикаментозная кардиоверсия (МКВ) [1]. Однако подтверждение сопоставимой эффективности и безопасности требовало прямого сравнения двух методов в ходе проспективного рандомизированного исследования, что и стало целью нашей работы

Расчет необходимого объема выборки
Включение больных в исследование
Процедуры исследования
Критерии эффективности проводившегося лечения
Статистическая обработка данных
Ограничения исследования
Клиническая характеристика больных
Анализ эффективности
Findings
Сравниваемый критерий
Full Text
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