Somberg John, Molnar Janos
Department of Medicine and Pharmacology Rush University, Chicago, IL; Department of Medicine and Pharmacology Rush University, Chicago, IL.
Department of Medicine and Pharmacology Rush University, Chicago, IL.
J Atr Fibrillation. 2016 Feb 29;8(5):1359. doi: 10.4022/jafib.1359. eCollection 2016 Feb-Mar.
The availability of intravenous (IV) Sotalol has equalized the treatment options since both amiodarone and sotalol are available in both IV and oral formulations. A review of the efficacy of sotalol as compared to amiodarone both for conversion of atrial fibrillation (AF) and maintenance of normal sinus rhythm (NSR) following cardiac surgery was undertaken. Standard methods of meta-analysis were employed. Full text publications of clinical trials written in English that compared the efficacy of sotalol to amiodarone were included in the analysis. For the conversion of AF to NSR, five studies were found eligible for the analysis. Two studies clinically compared sotalol to amiodarone for the maintenance of NSR after cardiac surgery. The common relative success of sotalol was 0.947 (95Cl: 0.837 to 1.071, P = 0.385), revealing essentially no differences in efficacy for conversion between amiodarone and sotalol. The average conversion rate was 47% with sotalol and 52% with amiodarone. The conversion rates were lower for persistent AF (sotalol 22% and amiodarone 27%), while greatest for recent onset AF (88% sotalol and 77% for amiodarone). The risk of developing post-operative atrial fibrillation was practically the same in both regimes, relative risk = 1.214 (95% CI: 0.815-1.808, p=0.339). In summary, sotalol and amiodarone are equally effective in AF conversion and maintenance of NSR post-cardiac surgery.
静脉注射索他洛尔的可获得性使治疗选择更加均衡，因为胺碘酮和索他洛尔都有静脉注射和口服两种剂型。我们对索他洛尔与胺碘酮在心脏手术后房颤（AF）转复及维持正常窦性心律（NSR）方面的疗效进行了综述。采用了标准的荟萃分析方法。分析纳入了以英文撰写的比较索他洛尔与胺碘酮疗效的临床试验全文出版物。对于房颤转复为NSR，发现有五项研究符合分析条件。两项研究在临床上比较了索他洛尔与胺碘酮在心脏手术后维持NSR的效果。索他洛尔的共同相对成功率为0.947（95%可信区间：0.837至1.071，P = 0.385），表明胺碘酮和索他洛尔在转复疗效上基本没有差异。索他洛尔的平均转复率为47%，胺碘酮为52%。持续性房颤的转复率较低（索他洛尔为22%，胺碘酮为27%），而近期发作房颤的转复率最高（索他洛尔为88%，胺碘酮为77%）。两种治疗方案中术后发生房颤的风险几乎相同，相对风险 = 1.214（95%可信区间：0.815 - 1.808，p = 0.339）。总之，索他洛尔和胺碘酮在心脏手术后房颤转复及维持NSR方面同样有效。
