Efficacy of amiodarone for the prevention of atrial fibrillation recurrence after cardioversion

• Published in: Cardiovascular Journal of Africa Vol. 32; no. 6; pp. 327 - 338
• Main Authors: Istratoaie, Sabina, Sabin, Octavia, Vesa, Ștefan C, Cismaru, Gabriel, Donca, Valer I, Buzoianu, Anca D
• Format: Journal Article
• Language: English
• Published: South Africa Clinics Cardive Publishing 01-11-2021
• Subjects: Amiodarone; Amiodarone - adverse effects; Anti-Arrhythmia Agents - adverse effects; Atrial fibrillation; Atrial Fibrillation - diagnosis; Atrial Fibrillation - drug therapy; Conversion; Electric Countershock - adverse effects; Electrophysiology; Humans; Quality of Life; Recurrence; Review; Treatment Outcome; atrial fibrillation; electrophysiology; amiodarone; conversion
• ISSN: 1995-1892; 1680-0745
• DOI: 10.5830/CVJA-2020-060

The restoration and maintenance of sinus rhythm is a desirable strategy for many patients with atrial fibrillation (AF) since it has been associated with improvement in symptoms and a better quality of life. Sinus rhythm can be achieved by pharmacological or electrical cardioversion or after catheter ablation of AF. Despite high rates of successful cardioversion, AF recurrence remains a major challenge. Anti-arrhythmic drug therapy currently plays a significant role in maintaining sinus rhythm after cardioversion. Amiodarone is the most commonly prescribed anti-arrhythmic drug for patients with AF. This is due to its particular electrophysiological proper-ties and superior anti-arrhythmic effects in comparison with other anti-arrhythmic drugs. Understanding the cardiac electrophysiology and arrhythmogenesis mechanisms may result in identification of new targets for anti-arrhythmic therapy. The aim of this article was to review amiodarone’s clinical pharmacology and evaluate evidence supporting amiodarone for treatment and prevention of AF recurrence after cardio-version.