The DOI matches its Crossref record; 65 of the 65 references it cites were found in a registry or an index.
Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation
Abstract
AIMS: Mixed treatment comparisons (MTC) were performed to assess the relative efficacy and tolerability of the main anti-arrhythmic drugs used for the treatment of atrial fibrillation (AF)/flutter. METHODS AND RESULTS: Electronic databases were systematically searched to identify randomized controlled trials (RCTs) examining amiodarone, dronedarone, flecainide, propafenone, sotalol, or placebo for the treatment of AF. Thirty-nine RCTs met inclusion criteria and were combined using MTC models to provide direct and indirect comparisons in a single analysis. Results are presented vs. placebo. Amiodarone had the largest effect in reducing AF recurrence (OR 0.22, 95% CI 0.16-0.29). Amiodarone was associated with the highest rate of patients experiencing at least one serious adverse event (OR 2.41, 95% CI 0.96-6.06) and treatment withdrawals due to adverse events (OR 2.91, 95% CI 1.66-5.11). Dronedarone was associated with the lowest rate of proarrhythmic events including bradycardia (OR 1.45, 95% CI 1.02-2.08). Dronedarone significantly reduced the risk of stroke (OR 0.69, 95% CI 0.57-0.84). Trends towards increased mortality for sotalol (OR 3.44, 95% CI 1.02-11.59) and amiodarone (OR 2.17, 95% CI 0.63-7.51) were found, which were stronger when small studies randomizing <100 subjects per group were excluded. CONCLUSIONS: Amiodarone has been demonstrated to be the most effective drug in maintaining sinus rhythm. Differences in outcomes between the anti-antiarrhythmic drugs were reported, with sotalol and possibly amiodarone increasing mortality and dronedarone possibly decreasing the incidence of serious adverse events and proarrhythmia.
Overview
Integrity signals
Registry
Cites
Statistics
Verification
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
In the citing paper
“Quinidine and disopyramide have been associated with an increase in all-cause mortality (OR 2.39; 95% CI 1.03-5.59;number needed to harm 109; 95% CI 34-4985) at 1-year follow-up, 580, 661 likely due to ventricular arrhythmias (torsades de pointes).580,661”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [661]
Citations
Cites
Cochrane Handbook for Systematic Reviews of Interventions: Cochrane Book Series
(2008) · doi:10.1002/9780470712184 · Cited by 25,048
Amiodarone or an Implantable Cardioverter–Defibrillator for Congestive Heart Failure
Bardy, G. H., Lee, K. L., Mark, D. B., Poole, J. E., Packer, D. L., Boineau, R., Domanski, M., Troutman, C., Anderson, J., Johnson, G., et al. (2005) · New England Journal of Medicine · doi:10.1056/nejmoa043399 · Cited by 6,552
Go, A. S., Hylek, E. M., Phillips, K. A., Chang, Y., Henault, L. E., Selby, J. V., & Singer, D. E. (2001) · JAMA · doi:10.1001/jama.285.18.2370 · Cited by 6,205
Beta blockade during and after myocardial infarction: An overview of the randomized trials
Yusuf, S., Peto, R., Lewis, J., Collins, R., & Sleight, P. (1985) · Progress in Cardiovascular Diseases · doi:10.1016/s0033-0620(85)80003-7 · Cited by 3,205
Miyasaka, Y., Barnes, M. E., Gersh, B. J., Cha, S. S., Bailey, K. R., Abhayaratna, W. P., Seward, J. B., & Tsang, T. S. M. (2006) · Circulation · doi:10.1161/circulationaha.105.595140 · Cited by 2,564
Combination of direct and indirect evidence in mixed treatment comparisons
Lu, G., & Ades, A. E. (2004) · Statistics in Medicine · doi:10.1002/sim.1875 · Cited by 2,172
What to add to nothing? Use and avoidance of continuity corrections in meta‐analysis of sparse data
J. Sweeting, M., J. Sutton, A., & C. Lambert, P. (2004) · Statistics in Medicine · doi:10.1002/sim.1761 · Cited by 1,734
Rhythm control versus rate control for atrial fibrillation and heart failure
Roy, D., Talajic, M., Nattel, S., Wyse, D. G., Dorian, P., Lee, K. L., Bourassa, M. G., Arnold, J. M. O., Buxton, A. E., Camm, A. J., et al. (2008) · New England Journal of Medicine · doi:10.1056/nejmoa0708789 · Cited by 1,585
Fuster, V., Rydén, L., Cannom, D. S., Crijns, H. J. G. M., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Heuzey, J. L., Kay, G. N., Lowe, J. E., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.009 · Cited by 1,161
Amiodarone to Prevent Recurrence of Atrial Fibrillation
Roy, D., Talajic, M. R., Dorian, P., Connolly, S. J., Eisenberg, M. J., Green, M. S., Kuś, T., Lambert, J., Dubuc, M., Gagné, P., et al. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003303421302 · Cited by 1,142
Research works printed but not linked: 6
- Wyndham, 2000, Texas Heart Institute journal / from the Texas Heart Institute of St. Luke's Episcopal Hospital, Texas Children's Hospital, 27, 257
- 1992, Journal of the American College of Cardiology, 19, 41A
- Carunchio, 1995, Giornale italiano di cardiologia, 25, 51
- 1991, N TRENDS ARRHYT, 7, 693
- Pritchett, 1991, Annals of Internal Medicine, 114, 539, 10.1059/0003-4819-114-7-539 · DOI
- 1995, Circulation, 92, 2550
Cited by
Sorted by citations
Items 201–244 of 244
Zhang, X., Jiang, R., Chen, Y., Lou, L., Liu, S., Sok, T., Han, J., Zhou, D., Zhang, B., Li, Z., et al. (2026) · EP Europace · doi:10.1093/europace/euag095 · Cited by 1
“30,31,36,37 The most significant cardiovascular side effect of amiodarone is sinus bradycardia, with QTc-interval prolongation also being common.”
Demarie, D., Orlando, F., Imazio, M., Cerrato, E., Richiardi, E., & Belli, R. (2014) · Journal of Advances in Medicine and Medical Research · doi:10.9734/bjmmr/2015/12626 · Cited by 1
“Amiodarone has been demonstrated to be the most effective drug in maintaining sinus rhythm and differences in outcomes between the anti-arrhythmic drugs were reported: sotalol and possibly amiodarone increased mortality, while dronedarone decreased the incidence of serious adverse events and pro-arrhythmia [17].”
BackgroundWutzler, A., Blaschke, F., Loehr, L., Meyer, T., Boldt, L., Nibbe, L., & Haverkamp, W. (2013) · International Journal of Cardiology · doi:10.1016/j.ijcard.2013.07.061 · Cited by 1
“Amiodarone has been shown to be the most effective drug in maintaining sinus rhythm [5] and should be considered in patients with suspected structural heart disease [2,6].”
BackgroundTešić, D., Kostić, M., Paunovic, D., & Јаnkovic, S. (2015) · Kardiologia Polska · doi:10.5603/kp.a2014.0228 · Cited by 1
Tresoldi, S. (2014) · Cardiovascular Pharmacology Open Access · doi:10.4172/2329-6607.1000116 · Cited by 1
Zirak, N., Soltani, G., Abbasi, M., Али, Moeinipour, A., Javan, H., Bagheri, K., & Shamloo, A. S. (2012) · Cited by 1
Uso de antiarrítmicos en el tratamiento de la fibrilación auricular. Estrategia de control del ritmo
Villegas-García, F. (2016) · Revista Colombiana de Cardiología · doi:10.1016/j.rccar.2016.10.018 · Cited by 1
Beşir, Y. (2015) · Turkish Journal of Thoracic and Cardiovascular Surgery · doi:10.5606/tgkdc.dergisi.2015.10315 · Cited by 1
“Freemantle et al.[20] also found that amiodarone was the most effective drug for maintaining sinus rhythm.”
BackgroundRosemann, A. (2022) · Praxis · doi:10.1024/1661-8157/a003916 · Cited by 1
Investigative agents for atrial fibrillation: agonists and stimulants, progress and expectations
Casado-Arroyo, R., Bernardi, M., Sabouret, P. F., Franculli, G., Tamargo, J. L., Spadafora, L., Lellouche, N., Biondi‐Zoccai, G., Toth, P. P., & Banach, M. (2024) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2024.2388583 · Cited by 1
Najeeb, H., Zaidi, S. F., Moeed, A., Yasmin, F., Asghar, M. S., Ullah, W., & Alraies, M. C. (2025) · Clinical Cardiology · doi:10.1002/clc.70149 · Cited by 1
Complex Congenital Heart Disease With Brady-Tachy Syndrome and Antitachycardia Pacing
Moe, T. G., Abrich, V. A., & Rhee, E. K. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-48568-5.00012-3 · Cited by 1
Reynolds, M. R., David, G., Gunnarsson, C., March, J. L., & Hao, S. C. (2014) · Journal of health economics and outcomes research · doi:10.36469/9881 · Cited by 1
Atrial High Rate Episodes and the Risk of Ventricular Arrhythmias
Upadhyay, G. A. (2019) · JACC. Clinical electrophysiology · doi:10.1016/j.jacep.2019.07.014 · Cited by 1
Walfridsson, U. (2011) · DiVA (Linkoping University) · Cited by 1
Trouillon, L. (2012) · OpenGrey (Institut de l'Information Scientifique et Technique)
Positive inotropic drugs and drugs used in dysrhythmias
Charpie, J. R., & Friedland‐Little, J. M. (2014) · Side effects of drugs annual · doi:10.1016/b978-0-444-62635-6.00017-6
Antiarrhythmic therapy of atrial fibrillation: are we treating too late?
Wasmer, K., Köbe, J., & Eckardt, L. (2014) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-014-0331-9
Naccarelli, G. V. (2014) · EP Europace · doi:10.1093/europace/eut427
“less efficacious than amiodarone in the prevention of recurrent AF, dronedarone appears to be a safer, well-tolerated drug in patients with preserved left ventricular function.(20,21) Dronedarone can be”
BackgroundPreventing Recurrences: Classic and Modern Antiarrhythmic Drugs in Atrial
Víctor, F., Jorge, T. R., & Lozano, I. F. (2015)
How Can We Avoid a Stroke Crisis in Europe
Andreotti, F., Camm, A. J., & Lobban, T. (2012)
Treatment Targets in Atrial Fibrillation
Kim, M. H. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2012.08.1027
“In addition, amiodarone, the priary AAD used in the AF-CHF trial, has been associated ith increased mortality despite being the most effective in reventing AF recurrence (14).”
BackgroundAntiarrhythmic therapy in patients with atrial fibrillation
Wysocka, A., Karaś-Głodek, M., & Wysokiński, A. P. (2015) · Postępy Nauk Medycznych
Sardar, M. R., Saeed, W., & Kowey, P. R. (2014)
Uued andmed viitavad liigsele agarusele dronedarooni kasutamisel kodade virvendusarütmia ravis
Irs, A., Laius, O., & Uusküla, M. (2014) · Ajakirjad. Journals by UT · doi:10.15157/ea.v0i0.10853
Outpatient Medications in Atrial Fibrillation
Newby, L. K., & Pokorney, S. D. (2016) · Contemporary cardiology · doi:10.1007/978-3-319-31386-3_18
Guía de práctica clínica para tratamiento de fibrilación auricular
Forero, V. H. (2015) · Revista Cuarzo · doi:10.26752/cuarzo.v21.n1.33
Safety and Efficacy of Dofetilide Therapy in a Veterans Affairs Population: The DT-VAP Study
Chen, F. (2017) · Pharmacy & Pharmacology International Journal · doi:10.15406/ppij.2017.05.00127
“The third death occurred at an outside hospital, where the patient was admitted for worsening shingles that according to the patient’s son started attacking the patient’s nerves ‡Includes post successful orthotopic heart transplant(1), discharge from cardiac EP service(1), patient choice(1), discontinuation at outside…”
BackgroundAntiarrhythmic Drug Management of Atrial Fibrillation
Camm, A. J., & Savelieva, I. (2017) · Cardiovascular medicine · doi:10.1007/978-3-319-58000-5_8
Balaji, S., Mandapati, R., & Webb, G. D. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-48568-5.00009-3
Unrepaired Primum Atrial Septal Defect With Atrial Fibrillation and Broad Complex Tachycardia
Balaji, S., Mandapati, R., & Webb, G. D. (2018) · Elsevier eBooks · doi:10.1016/b978-0-323-48568-5.00004-4
Saksena, S. V. (2012) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2011.11.043
Mohan, A., Majd, Z., Trinh, T., Paranjpe, R., & Abughosh, S. (2022) · Research Square · doi:10.21203/rs.3.rs-1200422/v1
Providencia, R. A., & Adragão, P. (2019) · Revista Portuguesa de Cardiologia (English Edition) · doi:10.1016/j.repce.2019.05.022
Antiarrhythmic Agents: a Review and Comment on Relevance in the Current Era—Part 2
Hanayneh, S., Panna, M. E., Miles, W. M., & Goel, R. (2021) · Current Treatment Options in Cardiovascular Medicine · doi:10.1007/s11936-021-00944-z
“dence pointing towards increasing mortality, likely owing to its potential proarrhythmic effects [10, 34].”
BackgroundFlecainide sebagai Antiaritmia untuk Fibrilasi Atrium dan Aritmia Lainnya
Clement, L. (2024) · Cermin Dunia Kedokteran · doi:10.55175/cdk.v51i4.948
Class III Antiarrhythmic Drugs
Delpón, E., Caballero, R., & Tamargo, J. L. (2024) · Springer eBooks · doi:10.1007/978-3-031-74046-6_5 · Cited by 1
Vorhofflimmern bei Ionenkanal-Erkrankungen und Kardiomyopathien
Kreimer, F., Gotzmann, M., & Eckardt, L. (2025) · DMW - Deutsche Medizinische Wochenschrift · doi:10.1055/a-2498-1571
“Antiarrhythmika wie Amio-daron sind insgesamt schlecht verträglich, haben ein pro-arrhythmisches Potenzial und können in einigen Fällen sogar mit einer erhöhten Mortalität assoziiert sein [14].”
Naccarelli, G. V., Rackley, J., & Boriani, G. (2025) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2025.100645
Emara, A., Mansour, A., Hamed, B. M., Elbataa, A., Azim, A. A. A., Elkasaby, M. H., Awashra, A., Shubietah, A. R. M., Jabbar, A. B. A., Rmilah, A. A. A., et al. (2026) · Cardiology in Review · doi:10.1097/crd.0000000000001452
Chen, M., Soejima, K., Gunawardene, M., Kojodjojo, P., Liu, H., Liu, T., Miyazaki, S., Morishima, I., Sanders, P., Tse, H., et al. (2026) · Journal of Arrhythmia · doi:10.1002/joa3.70492
Medikamentöse Rhythmuskontrolle bei Vorhofflimmern
Nowak, B., & Fürnkranz, A. (2014) · Herzschrittmachertherapie + Elektrophysiologie · doi:10.1007/s00399-014-0300-3
Metadata
- Authors
- Freemantle, N., Lafuente-Lafuente, C., Mitchell, S., Eckert, L., & Reynolds, M.
- Affiliations
- University of Birmingham (GB)
- Sanofi (France) (FR)
- Beth Israel Deaconess Medical Center (US)
- Corresponding author
- Eckert, L.
- Venue
- Europace
- Publisher
- Oxford University Press (OUP)
- Published
- 2011-01-11
- Volume
- 13
- Issue
- 3
- Pages
- 329-345
- ISSN
- 1099-5129 (ISSN-L)
- 1532-2092
- OpenAlex
- W2010627883
- Cited by
- 245
- References
- 65
- Citations by year
- 2026: 5 · 2025: 14 · 2024: 18 · 2023: 14 · 2022: 20 · 2021: 14 · 2020: 12 · 2019: 12 · 2018: 15 · 2017: 12 · 2016: 24 · 2015: 19 · 2014: 22 · 2013: 7 · 2012: 25
- FWCI
- 14.47
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- EP Europace (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- University of Birmingham Research Portal (University of Birmingham) (submittedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- atrial fibrillation, antiarrhythmic drugs, dronedarone, amiodarone, sotalol, flecainide, propafenone, atrial flutter, atrial fibrillation recurrence, drug-induced arrhythmia, stroke prevention, mortality, drug tolerability, sinus rhythm maintenance
- MeSH terms
- Dronedarone, Aged, Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Female, Flecainide, Humans, Male, Middle Aged, Propafenone, Sotalol, Randomized Controlled Trials as Topic, Treatment Outcome
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
