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An Integrative Comparative Study Between Digoxin and Amiodarone as an Emergency Treatment for Patients With Atrial Fibrillation With Evidence of Heart Failure: A Systematic Review and Meta-Analysis.
Zaki, Hany A; Bashir, Khalid; Iftikhar, Haris; Salem, Waleed; Mohamed, Eslam Hussein; Elhag, Helmy M; Hendy, Mohamed; Kassem, Ahmed Abdu O; Salem, Emad El-Din; Elmoheen, Amr.
Afiliação
  • Zaki HA; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Bashir K; Medicine, Qatar University, Doha, QAT.
  • Iftikhar H; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Salem W; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Mohamed EH; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Elhag HM; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Hendy M; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Kassem AAO; Accident and Emergency, Hamad Medical Corporation, Doha, QAT.
  • Salem EE; Emergency Medicine, Hamad Medical Corporation, Doha, QAT.
  • Elmoheen A; Anesthesia, Armed Forces Hospitals, Cairo, EGY.
Cureus ; 14(7): e26800, 2022 Jul.
Article em En | MEDLINE | ID: mdl-35971374
ABSTRACT
The emergency treatment of atrial fibrillation (AF) involves utilizing two strategies. The first strategy normally involves permitting the atrial fibrillation to persevere as the ventricular rate is controlled. The other method involves utilizing anti-arrhythmic drugs in cardioversion and attempting to maintain sinus rhythm. Different pharmacological treatments, including digoxin and amiodarone, have been used to manage AF. A literature review on amiodarone and digoxin in the treatment of AF among patients with heart failure (HF) has shown that both drugs have potential risks. Therefore, we are conducting this systematic review and meta-analysis to compare the effectiveness of amiodarone and digoxin in the treatment of AF among patients with evidence of HF. A literature search of relevant articles was conducted on six electronic databases (PubMed, Web of Science, Medline, ScienceDirect, Cochrane Library, and Google Scholar) from 2000 to 2022. The search yielded seven studies that had met the inclusion criteria. Our meta-analysis of four studies showed that there was no significant difference in the reduction of heart rate after treatment with either amiodarone or digoxin (mean difference (MD) -5.44; 95% confidence interval (CI) -9.53 to -1.34; I2 = 25%; p = 0.26). On the other hand, the statistical analysis showed that amiodarone had a better effect on the conversion to sinus rhythm than digoxin (63% versus 35%, respectively). Based on evidence from our meta-analysis, the clinical effect of amiodarone and digoxin in the emergency treatment of AF on heart rate control was unclear. However, amiodarone has a significant impact on the restoration of sinus rhythm compared with digoxin and can be considered the first-line drug regimen in conversion to sinus rhythm for AF patients with evidence of heart failure. However, the use of amiodarone and digoxin is complicated by adverse events and all-cause mortality.
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Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Systematic_reviews Idioma: En Ano de publicação: 2022 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Tipo de estudo: Systematic_reviews Idioma: En Ano de publicação: 2022 Tipo de documento: Article