Does the choice of drug in pharmacologic cardioversion correlate with the guidelines? Systematic review.
antiarrhythmic
atrial fibrillation
cardioversion
guideline adherence
Journal
Advances in clinical and experimental medicine : official organ Wroclaw Medical University
ISSN: 1899-5276
Titre abrégé: Adv Clin Exp Med
Pays: Poland
ID NLM: 101138582
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
pubmed:
24
3
2021
medline:
7
4
2021
entrez:
23
3
2021
Statut:
ppublish
Résumé
Atrial fibrillation (AF) is the most common sustained arrhythmia, the most common cause of supraventricular tachycardia in the global population and the most common arrhythmia requiring treatment in an emergency department. To systematically review recent literature and quantify the correlation between the choice of pharmacological cardioversion (PCV) drug and the national or international guidelines. A systematic review was performed in accordance with the PRISMA statement methodology. The PubMed search engine was used to search for articles regardless of type or language and published in the last 6 years (May 2014-May 2020). In addition, we searched for AF guidelines and recommendations published online by cardiology and emergency medicine societies. The search strategy returned a total of 2615 abstracts. A total of 2598 full texts were screened; 2540 full texts were excluded with reasons and 58 articles from 32 countries were included in the analysis. In 17 of the 58 articles (29%), we noted discrepancies with the AF guidelines, specifically regarding the PCV drug used, the patients' comorbidities and the contraindications associated with the PCV drug. The most common clinical situation for the use of a contraindicated drug was when ibutilide was administered to patients with heart failure. The analysis did not reveal any statistically significant correlations, although the correlation between the sample size and guideline adherence was close to statistical significance (p < 0.06). Our systematic analysis revealed substantial non-adherence to AF treatment guidelines.
Sections du résumé
BACKGROUND
BACKGROUND
Atrial fibrillation (AF) is the most common sustained arrhythmia, the most common cause of supraventricular tachycardia in the global population and the most common arrhythmia requiring treatment in an emergency department.
OBJECTIVES
OBJECTIVE
To systematically review recent literature and quantify the correlation between the choice of pharmacological cardioversion (PCV) drug and the national or international guidelines.
MATERIAL AND METHODS
METHODS
A systematic review was performed in accordance with the PRISMA statement methodology. The PubMed search engine was used to search for articles regardless of type or language and published in the last 6 years (May 2014-May 2020). In addition, we searched for AF guidelines and recommendations published online by cardiology and emergency medicine societies.
RESULTS
RESULTS
The search strategy returned a total of 2615 abstracts. A total of 2598 full texts were screened; 2540 full texts were excluded with reasons and 58 articles from 32 countries were included in the analysis. In 17 of the 58 articles (29%), we noted discrepancies with the AF guidelines, specifically regarding the PCV drug used, the patients' comorbidities and the contraindications associated with the PCV drug. The most common clinical situation for the use of a contraindicated drug was when ibutilide was administered to patients with heart failure. The analysis did not reveal any statistically significant correlations, although the correlation between the sample size and guideline adherence was close to statistical significance (p < 0.06).
CONCLUSION
CONCLUSIONS
Our systematic analysis revealed substantial non-adherence to AF treatment guidelines.
Identifiants
pubmed: 33757165
doi: 10.17219/acem/130592
doi:
Substances chimiques
Anti-Arrhythmia Agents
0
Pharmaceutical Preparations
0
Sulfonamides
0
Types de publication
Journal Article
Review
Systematic Review
Langues
eng
Sous-ensembles de citation
IM