Pharmacological Cardioversion of Atrial Tachyarrhythmias Using Single High-Dose Oral Amiodarone: A Systematic Review and Meta-Analysis

摘要

Atrial tachyarrhythmias (ATAs) are common, with =25% lifetime prevalence >40 years.1 A recent multicenter study of 2789 patients with ATA and existing cardiovascular conditions found fewer major adverse cardiovascular outcomes (hazard ratio=0.79 [0.66-0.94], P=0.005)2 with early rhythm control than rate control. However, cardioversion to sinus rhythm (SR) can be challenging. Electrical cardioversion is highly effective but requires conscious sedation in monitored hospital settings, and safety concerns limit class IC medication use. A single, high dose of oral amiodarone is appealing due to convenience, low cost, and favorable safety profile. We performed a systematic review and meta-analysis to evaluate the efficacy of single, high-dose oral amiodarone for pharmacological conversion of ATA within 24 hours of drug administration.