Pharmacological conversion of recent-onset atrial fibrillation: A systematic review

Figures & data

Table I. Drugs that were included in the PubMed searches.

a)	Ajmaline
b)	Amiodarone
c)	Atenolol
d)	Azimilide
e)	Bisoprolol
f)	Carvedilol
g)	Digoxin
h)	Diltiazem
i)	Disopyramide
j)	Dofetilide
k)	Esmolol
l)	Flecainide
m)	Ibutilide
n)	Metoprolol
o)	Pilsicainide
p)	Procainamide
q)	Propafenone
r)	Propranolol
s)	Quinidine
t)	Sotalol
u)	Timolol
v)	Verapamil
w)	Vernakalant

Table II. Drugs for which no relevant papers emerged and number of studies generated for each drug, according to the search criteria.

Ajmaline	2
Atenolol	37
Azimilide	12
Bisoprolol	9
Carvedilol	23
Disopyramide	29
Dofetilide	23
Esmolol	15
Metoprolol	46
Propranolol	23
Timolol	5

Table III. Drugs with one or more relevant papers, A number of studies found according to search criteria, B number of relevant studies with placebo (or ineffective drug) control and C number of patients given drug or placebo according to column B.

	A	B	C
Amiodarone	272	13	1286
Digoxin	179	4	397
Diltiazem	61	0	0
Flecainide	92	5	472
Ibutilide	46	1	74*
Pilsicainide	12	1	75
Procainamide	32	2	263
Propafenone	117	13	1615
Quinidine	52	1	61
Sotalol	115	2	136
Verapamil	93	0	0
Vernakalant	7	4	700

*Assuming equal numbers given placebo in this subgroup.

Table IV. Studies comparing amiodarone to control, placebo or other drugs with proven lack of efficacy.

	Patients (Relevant)	Duration AF	Control	Other Drug	Time to Endpoint	SR Amio	SR Control	References
1	24	≤ 2 d	Verapamil		3 hours	77%	0%	(1)
2	62 (40)	≤ 7 d	Placebo	Flecain.	3 hours	16%	29%	(2)
					8 hours	37%	48% ns
3	50 (39)	≤ 10 d	Digoxin		24 hours	95%	74%	(3)
4	98 (64)	≤ 3 d	Placebo	Flecain.	2 hours	34%	22% ns	(4)
					8 hours	59%	56% ns
5	100	≤ 7 d	Placebo		24 hours	68%	60% ns	(5)
6	417 (172)	≤ 7 d	Placebo	Flecain. Propafen.	1 hour	6%	9% ns	(6)
					3 hours	25%	18% ns
					8 hours	57%	37%
7	143 (97)	≤ 2 d	Placebo	Propafen.	24 hours	83%	55%	(7)
8	100	≤ 2 d	Placebo		24 hours	92%	64%	(8)
9	62	≤ 2 d	Placebo		8 hours	50%	20%	(9)
					24 hours	87%	35%
10	208 (106)	≤ 1 d	Placebo		1 hour	61%	45% ns	(10)
11	160	≤ 1 d	Placebo		8 hours	50%	26%	(11)
					20 hours	83%	44%
12	140	≤ 2 d (80%)	Digoxin Sotalol		12 hours	51%	50/44% ns	(12)
13	362 (182)	≤ 2 d	Placebo		24 hours	89%	61%	(13)

Several studies comprised more than one active drug, mentioned in column “other drug”; accordingly both total numbers of patients as well as number of relevant patients for the drug in question are given in the first column.

Table V. Studies comparing digoxin to placebo.

	No patients	AF duration	SR within	SR dig IV	SR dig PO	SR placebo	References
1	36	≤ 7 d	18 hours		50%	44% ns	(14)
2	40	≤ 7 d	12 hours	47%		40% ns	(15)
3	239	≤ 7 d	16 hours	51%		46% ns	(16)
4	123 (82)	≤ 3 d	1 hour	32%	(Propafenone)	14% ns	(17)

Table VI. Studies comparing flecainide to placebo (1–4) or drugs with proven lack of effect (5).

	Patients (Relevant)	AF duration	SR within	SR IV	SR PO	SR placebo	SR other	References
1	102	≤ 3 d	1 hour	57%		14%		(20)
			6 hours	67%		35%
							Amio
2	98 (66)	≤ 3 dh	2 hours	59%		22%	34%	(4)
			8 hours	68%		56% ns	59%
							Amio
3	62 (43)	≤ 7 d	3 hours		68%	16%	29%	(2)
			8 hours		91%	48%	37%
							Amio
4	417 (190)	≤ 7 d	1 hour		13%	9%	6%	(6)
			3 hours		57%	18%	25%
			8 hours		75%	37%	57%
						Sotalol
5	71	≤ 1 d	2 hours	69%		31%		(21)

Several studies comprised more than one active drug, mentioned in column “other drug”; accordingly both total numbers of patients as well as number of relevant patients for the drug in question are given in the first column.

Table VII. Studies comparing propafenone to placebo.

	No patients	AF duration	SR within	SR drug IV	SR drug PO	SR placebo	References
1	87	≤ 7 days	1 hour	28%	3%	3%	(27)
			3 hours	41%	55%	10%
			8 hours	66%	69%	24%
2	75	≤ 3 days	3 hours	59%		29%	(28)
3	182	≤ 7 days	4 hours	79%		0%	(29)
			24 hours	91%		32%
4	105	≤ 3 days	2 hours		43%	11%	(30)
			4 hours		57%	17%
			24 hours		80%	69%-ns
5	240	≤ 7 days	3 hours		45%	18%	(31)
			8 hours		76%	37%
6	55	≤ 7 days	2 hours		41%	8%	(32)
			6 hours		65%	31%
			12 hours		69%	42%
			24 hours		79%	73%-ns
7	156	≤ 3 days	2 hours	70%		17%	(33)
8	123	≤ 3 days	1 hour	48%	15%	17%	(34)
			8 hours	53%	78%	48%

Table IX. Studies comparing vernakalant to control.

	No patients	AF duration	SR within	SR drug IV	SR amio	SR placebo	References
1	56	≤ 3 days	0.5 hour	61%		5%	(42)
2	220	≤ 7 days	1.5 hours	52%		4%	(43)
3	170	≤ 7 days	1.5 hours	51%		4%	(44)
4	254	≤ 2 days	1.5 hours	52%	5%		(45)

Table VIII. Studies comparing propafenone to another drug and placebo.

	No patients (Relevant)	AF duration	SR within	SR drug IV	SR drug PO	SR placebo	Other -	drugs	References
9	87	≤ 8 days					Dig		(35)
			6 hours		62%	17%	38%
			12 hours		83%	34%
			24 hours		86%	55%
							Dig
10	123	≤ 3 days	1 hour	49%		14%	32%		(17)
							Amio
11	143 (95)	≤ 2 days	24 hours	78%		55%	83%		(7)
							Dig/Quin	Prop/dig
12	246 (106)	≤ 2 days	3 hours		48%	27%	20%	50%	(36)
			24 hours		70%	77%(ns)	85%	88%
							Amio iv	Proc iv
13	362 (181)	≤ 2 days	24 hours	80%		61%	89%	69%	(13)

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