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.
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“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]
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“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) Recent onset AF”
2012 focused update of the ESC Guidelines for the management of atrial fibrillation
Authors Task Force Members, Camm, A. J., Lip, G. Y. H., Caterina, R. D., Savelieva, I., Atar, D., Hohnloser, S. H., Hindricks, G., Kirchhof, P. F., Bax, J. J., et al. (2012) · EP Europace · doi:10.1093/europace/eus305 · Cited by 3,823
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
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