The funding source had no role in the design and conduct of the study the extraction, management, analysis, or interpretation of the data or the preparation, review, or approval of the manuscript.Ĭompeting interests: The authors have declared that no competing interests exist.Ītrial fibrillation is the most common arrhythmia of the heart with a prevalence of approximately 2% in the western world.
A FIB VS A FLUTTER TRIAL
This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.ĭata Availability: All relevant data are within the paper and its Supporting Information files.įunding: The Copenhagen Trial Unit paid the salary for all authors during the writing of this review. Received: JAccepted: FebruPublished: March 8, 2018Ĭopyright: © 2018 Sethi et al. Bishopric, University of Miami School of Medicine, UNITED STATES Meta-analysis on acute conversion to sinus rhythm showed that digoxin compared with amiodarone reduced the probability of converting atrial fibrillation to sinus rhythm, but TSA showed that we lacked information (RR, 0.54 TSA-adjusted CI, 0.13 to 2.21 I 2 = 0%).Ĭitation: Sethi NJ, Nielsen EE, Safi S, Feinberg J, Gluud C, Jakobsen JC (2018) Digoxin for atrial fibrillation and atrial flutter: A systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. Meta-analyses on acute heart rate control showed that digoxin was inferior compared with both calcium antagonists (MD, 21.0 bpm TSA-adjusted CI, -30.3 to 72.3) and with amiodarone (MD, 14.7 bpm TSA-adjusted CI, -0.58 to 30.0 I 2 = 42%), but in both comparisons TSAs showed that we lacked information. Our analyses on acute heart rate control (within 6 hours of treatment onset) showed firm evidence of digoxin being superior compared with placebo (mean difference (MD), -12.0 beats per minute (bpm) TSA-adjusted CI, -17.2 to -6.76 I 2 = 0%) and inferior compared with beta blockers (MD, 20.7 bpm TSA-adjusted CI, 14.2 to 27.2 I 2 = 0%). When digoxin was compared with all control interventions in one analysis, we found no evidence of a difference on all-cause mortality (risk ratio (RR), 0.82 TSA-adjusted confidence interval (CI), 0.02 to 31.2 I 2 = 0%) serious adverse events (RR, 1.65 TSA-adjusted CI, 0.24 to 11.5 I 2 = 0%) quality of life heart failure (RR, 1.05 TSA-adjusted CI, 0.00 to 1141.8 I 2 = 51%) and stroke (RR, 2.27 TSA-adjusted CI, 0.00 to 7887.3 I 2 = 17%). All were at high risk of bias and reported only short-term follow-up.
28 trials (n = 2223 participants) were included.
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