Arrhythmias & electrophysiologyMeta-analysis
Intravenous Amiodarone in Preexcited Atrial Fibrillation: A Systematic Review
- systematic review
- conjugate β-binomial model with prespecified weak priors
- multinational survey of Latin American emergency departments
Authors' conclusion
Taken together, population-level evidence suggests that the risk of VF in preexcited AF following intravenous amiodarone administration is rare. In settings where guideline-recommended drugs are inaccessible, intravenous amiodarone may represent a clinically reasonable alternative for rhythm or rate control.
Study context
- Population
- Patients with Wolff-Parkinson-White syndrome presenting with preexcited atrial fibrillation (AF) who received intravenous amiodaroneTwelve studies (7 case reports, 2 cohorts, 3 before-and-after interventional studies) · observational and interventional cohorts assessing patients with preexcited AF 146
- Participants
- 177 patients
Pooled result
As reported in the abstract
Case reports describing transient ventricular rate acceleration or ventricular fibrillation (VF)
Four
Further pooled results
Acceleration or VF in observational and interventional cohorts
- No acceleration or VF observed (n=146)
Posterior mean estimates of VF risk · during or following infusion
- Posterior mean estimates of VF risk ranged over priors
- 0.12% to 0.68%
Anterograde effective refractory period of the atrioventricular node and AP · following amiodarone administration
- Significant increase across 3 interventional before-and-after studies
Access to class IIa/IIb indicated agents in Latin American emergency centers (survey)
- Emergency centers responding
- 10
- None had access to class IIa/IIb indicated agents; all had intravenous amiodarone available
Original publication
Summarised from the published abstract; every number is checked against it