Effectiveness of antazoline versus amiodarone, flecainide and propafenone in restoring sinus rhythm at the emergency department

IF 2.5 4区医学 Q3 MEDICINE, RESEARCH & EXPERIMENTAL Advances in medical sciences Pub Date : 2024-04-20 DOI:10.1016/j.advms.2024.04.003

Janusz Springer , Michalina Pejska , Wojciech Homenda , Tomasz Zdrojewski , Ludmiła Daniłowicz-Szymanowicz , Dariusz Kozłowski

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Abstract

Purpose

Little is known about the effectiveness of pharmacological cardioversion (PCV) with antazoline in comparison to flecainide. The aim of this study was to compare the effectiveness of antazoline in restoring sinus rhythm (SR) versus amiodarone, flecainide and propafenone in a group of emergency department (ED) patients.

Materials/methods

This was a single-centre retrospective analysis of patient records from an ED in a large hospital in Poland. We analysed a total of 1878 patient records, divided based on the anti-arrhythmic drug (AAD) administered during PCV: antazoline (n = 1080), antazoline + β-blocker (n = 479), amiodarone (n = 129), flecainide (n = 102), propafenone (n = 88). Of the patients, 63.5 % were female (median 65 years, [19–100]).

Results

The percentage of successful PCV was significantly higher in the antazoline group (84.3 %) than in the antazoline + β-blocker (75.8 %, p = 0.0001), propafenone (75.6 %, p = 0.0364) and amiodarone (68.8 %, p < 0.0001) groups. Post-hoc analysis revealed that patients who received PCV with antazoline, antazoline + β-blocker, flecainide and propafenone had significantly shorter time to SR than those who received amiodarone (p < 0.0001). Univariate regression analysis revealed that patients who underwent PCV with antazoline were almost twice as likely to return to SR compared to the other groups (p < 0.0001, OR 1.81, 95 % CI 1.44–2.27).

Conclusions

This is the first study comparing the effectiveness of antazoline in PCV versus flecainide in addition to the previously studied amiodarone and propafenone. Our results indicate that antazoline is more effective in restoring SR than amiodarone, flecainide and propafenone. In addition, antazoline restored SR significantly faster than amiodarone or propafenone.

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安他唑啉与胺碘酮、非卡内酯和普罗帕酮在急诊科恢复窦性心律的效果对比。

目的关于使用安他唑啉进行药理心脏转复（PCV）与使用氟卡尼进行药理心脏转复（PCV）的效果，人们知之甚少。本研究旨在比较安他唑啉与胺碘酮、非卡尼和普罗帕酮在一组急诊科（ED）患者中恢复窦性心律（SR）的效果。我们共分析了 1878 份病历，根据 PCV 期间使用的抗心律失常药物 (AAD) 进行了划分：安他唑啉（1080 例）、安他唑啉 + β-受体阻滞剂（479 例）、胺碘酮（129 例）、非卡内酯（102 例）、普罗帕酮（88 例）。结果安他唑啉组 PCV 成功率（84.3%）显著高于安他唑啉 + β-受体阻滞剂组（75.8%，p = 0.0001）、普罗帕酮组（75.6%，p = 0.0364）和胺碘酮组（68.8%，p < 0.0001）。事后分析显示，接受安他唑啉、安他唑啉+β-受体阻滞剂、非卡奈德和普罗帕酮 PCV 的患者的 SR 时间明显短于接受胺碘酮的患者（p < 0.0001）。单变量回归分析显示，与其他组别相比，使用安他唑啉进行 PCV 的患者返回 SR 的几率几乎是其他组别的两倍（p < 0.0001，OR 1.81，95 % CI 1.44-2.27）。我们的研究结果表明，安他唑啉在恢复 SR 方面比胺碘酮、非卡因和普罗帕酮更有效。此外，安他唑啉恢复 SR 的速度明显快于胺碘酮或普罗帕酮。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Advances in medical sciences 医学-医学：研究与实验

CiteScore

5.00

自引率

0.00%

发文量

审稿时长

25 days

期刊介绍： Advances in Medical Sciences is an international, peer-reviewed journal that welcomes original research articles and reviews on current advances in life sciences, preclinical and clinical medicine, and related disciplines. The Journal’s primary aim is to make every effort to contribute to progress in medical sciences. The strive is to bridge laboratory and clinical settings with cutting edge research findings and new developments. Advances in Medical Sciences publishes articles which bring novel insights into diagnostic and molecular imaging, offering essential prior knowledge for diagnosis and treatment indispensable in all areas of medical sciences. It also publishes articles on pathological sciences giving foundation knowledge on the overall study of human diseases. Through its publications Advances in Medical Sciences also stresses the importance of pharmaceutical sciences as a rapidly and ever expanding area of research on drug design, development, action and evaluation contributing significantly to a variety of scientific disciplines. The journal welcomes submissions from the following disciplines: General and internal medicine, Cancer research, Genetics, Endocrinology, Gastroenterology, Cardiology and Cardiovascular Medicine, Immunology and Allergy, Pathology and Forensic Medicine, Cell and molecular Biology, Haematology, Biochemistry, Clinical and Experimental Pathology.