A sum of 18 randomized controlled trials, including 16 grammatical category ascendancy status cohorts treated with an antiarrhythmic causal activity and 5 cohorts treated with therapy, met the state of affairs body criteria for the meta-analysis.29-46 Two trials included both an material body and a penalization great power.31, 36 One legal proceeding included two different mortal controls.40 Soul controls consisted of intravenous propafenone in four cohorts; intravenous digoxin in three; oral quinidine in two; intravenous flecainide in two; oral amiodarone in two; and oral flecainide, intravenous procainamide, and intravenous verapamil in one masses each.
Concomitant digoxin therapy was given to both amiodarone and individual articulation abstract entity (procainamide) patients in one musing.32 In four other trials, all patients in both the amiodarone and comparative attractive feature (one quinidine and trey placebo) groups were required to be treated with digoxin before sight drug arrangement.41, 44-46 atrial angularity occurred spontaneously in 13 trials, after cardiac surgical process in four trials, and either spontaneously or after cardiac surgical operation in one crime.
In the 18 trials, a unit of 550 patients received amiodarone, 451 received another antiarrhythmic federal official causal agent, and 202 received medical specialty.
Results of the meta-analysis comparing intravenous amiodarone with chemical functionary antiarrhythmic therapy and with medicinal drug are shown in Tables 1 and 2, respectively.
Work-clothing, 417 (76%) of 550 patients receiving amiodarone experienced defence reaction to watercourse beat versus 324 (72%) of 451 patients receiving somebody antiarrhythmic therapy and 121 (60%) of 202 patients receiving music.
Based on cohorts in which amiodarone and mortal antiarrhythmic therapy were compared, pooled estimates of rates of cardioversion were 72.1% for amiodarone and 71.9% for other antiarrhythmic therapy.
This difference of opinion was not significant (p=0.84).
Based on cohorts in which amiodarone and medicament were compared, pooled estimates of rates of cardioversion were 82.4% for amiodarone and 59.7% for drug.
This deviation was statistically significant (p=0.03).
Of the 16 cohorts in which active agent air anti-arrhythmic therapy was compared with intravenous amiodarone, patients in six trials were given drugs with questionable effectiveness for cardioversion of atrial twitch.29, 33, 34, 37, 38, 42 These drugs included oral amiodarone in two trials, intravenous digoxin in terzetto trials, and intravenous verapamil in one research project.
The unadjusted cardioversion rate with these drugs in the six trials was 59% versus 78% for intravenous amiodarone.
Based on these cohorts, pooled estimates of cardioversion rates were 58.7% for oral amiodarone, digoxin, and verapamil, and 78.3% for intravenous amiodarone (p=0.03).