Cover of Non-ablative rate control therapies

Non-ablative rate control therapies

Atrial fibrillation: diagnosis and management

Evidence review I

NICE Guideline, No. 196

Authors

.

London: National Institute for Health and Care Excellence (NICE); .
ISBN-13: 978-1-4731-4043-1
Copyright © NICE 2021.

1. Rate control

1.1. Review question: What is the clinical and cost effectiveness of different non-ablative rate control therapies in people with atrial fibrillation?

1.2. Introduction

In atrial fibrillation (AF) ventricular rate control is the one of the cornerstones of therapy and is usually sufficient to alleviate symptoms due to AF. AF with fast ventricular rates is a major contributing factor exercise limitation and disability. Unabated fast AF may lead to left ventricular dysfunction and heart failure.

The ventricular rate response to atrial fibrillation is dependent on atrio-ventricular (AV) node conduction and is influenced by autonomic tone. Alleviation of symptoms requires appropriate ventricular rate control both at rest and during exertion when rate response to AF may increase disproportionately. AV node conduction in response to AF varies considerably and some patients may not require rate control.

Non-ablative rate control in both the acute and non-acute settings is achieved by categories of drugs that slow AV node conduction including beta blockers, rate limiting calcium channel blockers, and digoxin. Amiodarone also slows AV node conduction and maybe used in the acute phase particularly where there is evidence of haemodynamic instability or severely impaired left ventricular (LV) function. These drugs may be used alone but combinations are often required. Even so, rate control remains challenging particularly when choice is limited drug intolerance and patient factors (e.g. rate limiting calcium channel blockers are contraindicated in severe LV dysfunction). This evidence review aims to assess the effectiveness of these different AV node slowing drugs in the rate control of atrial fibrillation both in the acute and non-acute settings.

1.3. PICO table

For full details see the review protocol in Appendix A:.

Table 1. PICO characteristics of review question.

Table 1

PICO characteristics of review question.

1.4. Methods and process

This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual.103Methods specific to this review question are described in the review protocol in Appendix A:.

Declarations of interest were recorded according to NICE’s 2018conflicts of interest policy.

1.5. Clinical evidence

1.5.1. Included studies

A search was conducted to identify randomised controlled trials or systematic reviews of randomised controlled trials comparing different strategies for rate control in non-valvular atrial fibrillation(NVAF), including beta-blockers, calcium channel blockers, digoxin, amiodarone and any combinations of these agents. Five studies(from six papers)were included in the review;57, 74, 76, 135, 140, 151these are summarised in Table 2 below. Evidence from these studies is summarised in the clinical evidence summary below (Table 3).

Studies were included in this review only if the primary aim of the interventions was for rate control, and not for the restoration or control of sinus rhythm. The majority of the included studies employed intravenous administration of the drugs rather than oral doses and were set in secondary care, including over half in the emergency department for the treatment of acute AF. The included studies covered the following comparisons between the interventions listed in the protocol for this review:

  • Four studies compared amiodarone with digoxin.57, 135, 140, 151Three of these used intravenous administration with one using oral administration.
  • One study (two papers) compared beta-blockers (carvedilol) with digoxin74, 76. The study design was complex and involved two phases – one where carvedilol or placebo was initiated and a second where digoxin was either continued or discontinued to compare between a group receiving carvedilol alone and another group receiving digoxin alone at the end of the study. This study used oral administration of the drugs.

Not all of the studies explicitly stated that they covered a NVAF population; those with valvular disease as an exclusion criterion or those with no mention of concomitant valve disease within the population were included in the review, while studies where it was clear >10% of the population had experienced concomitant valve disease were excluded from the review.

It is also noted that studies that included intravenous use of diltiazem as one of the comparators were not included in the review, as this is not available for use in the UK in this form.

See also the study selection flow chart in Appendix C:, study evidence tables in Appendix D:, forest plots in Appendix E: and GRADE tables in Appendix H:.

1.5.2. Excluded studies

See the excluded studies list in Appendix I.

1.5.3. Summary of clinical studies included in the evidence review

Table 2. Summary of studies included in the evidence review.

Table 2

Summary of studies included in the evidence review.

See Appendix D:for full evidence tables.

1.5.4. Quality assessment of clinical studies included in the evidence review

Table 3. Clinical evidence summary: Amiodarone vs. digoxin.

Table 3

Clinical evidence summary: Amiodarone vs. digoxin.

Table 4. Clinical evidence summary: Beta-blockers vs. digoxin.

Table 4

Clinical evidence summary: Beta-blockers vs. digoxin.

See Appendix F:for full GRADE tables.

1.6. Economic evidence

1.6.1. Included studies

No health economic studies were included.

1.6.2. Excluded studies

No relevant health economic studies were excluded due to assessment of limited applicability or methodological limitations.

See also the health economic study selection flow chart in Appendix G:.

1.6.3. Unit costs

Relevant drug unit costs are provided in Table 5to aid consideration of costeffectiveness.

Table 5. Drug unit costs.

Table 5

Drug unit costs.

1.7. The committee’s discussion of the evidence

1.7.1. Interpreting the evidence

1.7.1.1. The outcomes that matter most

All outcomes listed in the protocol for this review, which comprised health-related quality of life, mortality, hospitalisation, heart failure/exacerbation of heart failure and failure of non-ablative rate control, were considered by the committee to be critical for decision-making. No additional important outcomes were specified in the protocol.

In this review, no clinical evidence was identified for the hospitalisation outcome for any of the comparisons specified in the protocol.

1.7.1.2. The quality of the evidence

The quality of the evidence for all outcomes included in this review was of very low quality according to GRADE analysis. The primary reasons for this were a very high risk of bias due to issues with selection and blinding of participants and attrition, as well as imprecision detected for all included outcomes.

Inconsistency, which refers to the presence of heterogeneity between effects across different studies in a meta-analysis, was also an issue for one of the outcomes in the amiodarone vs. digoxin comparison.

Limited evidence was identified for this review, and the available evidence only covered two comparisons: amiodarone vs. digoxin and beta blockers vs. digoxin. In terms of interpreting the evidence, imprecision made it difficult for the committee to determine the true effect of the interventions relative to one another, as there was too much uncertainty. This uncertainty was exacerbated by the fact that for most of the reported outcomes, pooling of multiple studies was not possible and effect sizes were based on only one study with small numbers of participants. These limitations in the amount and quality of the evidence meant that the committee did not feel able to change existing recommendations based on the evidence, and instead changes were made based on consensus and current practice.

1.7.1.3. Benefits and harms

The evidence included in this review was obtained from five RCTs, with evidence available for the comparisons between beta-blockers and digoxin, and amiodarone and digoxin.

For the amiodarone vs. digoxin comparison, there was some evidence to suggest a benefit of amiodarone over digoxin in terms of failure of non-ablative rate control, with a meta-analysis consisting of three studies indicating fewer failures in the amiodarone group compared with the digoxin group. However, concerns were raised by the committee about whether the time-point at which failure of rate control was measured was suitable to be able to detect effects of digoxin; one study measured rate control failure at 30 min post-initial dose, which was considered to be too short to measure an effect of digoxin and therefore the time-point at which this outcome was measured may have been biased towards amiodarone for this study.

There was no clear evidence for any of the other outcomes reported for this comparison. One study provided data on the quality of life of those receiving oral doses of amiodarone or digoxin; however, this was based on a very small number of participants and there was too much variability in effect sizes for most of the quality of life domains to determine whether a difference existed between the two groups. Additionally, the committee noted that the composite mental and physical scores that are usually reported for the SF-36 quality of life scoring system had not been reported in this study, suggesting that there was likely to be no important difference between the two groups overall and this may be why these composite scores were not reported in the study. Similarly, no strong evidence favouring either amiodarone or digoxin in studies with intravenous dosing in the emergency department was available for in-hospital mortality or heart failure onset outcomes, with either no clinical difference being reported or substantial variation in the effect estimate making it difficult to determine the true effect.

For the beta-blockers vs. digoxin comparison, only one study was available, which compared oral dosing with carvedilol or digoxin. Although point estimates appeared to favour digoxin in terms of mortality and worsening of heart failure symptoms during the second phase of this trial, the wide confidence intervals meant that there was substantial uncertainty in the true effect.

As the committee considered the evidence to be insufficient to support significant changes to the current recommendations in this area, the committee instead amended the existing recommendations based on consensus and current practice. The committee noted that recommendations for chronic heart failure were published in 2018 (NICE guideline NG106) and when considering drug therapy in those with atrial fibrillation and chronic heart failure, clinicians should refer to the chronic heart failure guideline for the use of calcium channel blockers, as it advises that calcium channel blockers such as diltiazem and verapamil be avoided in those with heart failure and reduced left ventricular ejection fraction. Additionally, the chronic heart failure guideline (NICE guideline NG106) had already reviewed the evidence for beta-blockers vs. placebo in those with atrial fibrillation and heart failure by including an individual patient data meta-analysis of atrial fibrillation subsets of heart failure trials; no recommendations were made regarding the use of beta-blockers in those with atrial fibrillation and heart failure. There was some evidence of a small increase in all-cause mortality and stroke but the chronic heart failure committee were not confidence in the effect estimate due to the presence of very serious imprecision. The evidence did not show a clinical important reduction in the number of heart failure hospitalisations. Due to the uncertainty in the evidence the committee made a research recommendation. Therefore, to avoid contradicting decisions made in NG106 based on the same set of evidence, the individual patient data meta-analysis mentioned above was not included in the review, and it was agreed that referring to NG106 for beta-blocker use in those with atrial fibrillation and chronic heart failure was preferable.

The existing recommendation of beta-blockers or rate-limiting calcium channel blockers as the choice for initial rate control treatment in those requiring a rate control strategy was retained by the committee as they agreed that this recommendation was still current practice and there was insufficient evidence to suggest an alternative recommendation, with potential adverse events of other alternative options being highlighted. The committee agreed that the choice should still be made based on the symptoms, heart rate, comorbidities and preferences of those being treated. The committee also agreed with the existing recommendations for this area concerning combination therapy options if initial monotherapy fails and the decision not to use amiodarone long-term, as the evidence included in the review was insufficient to suggest otherwise and there were significant concerns about the serious side effects associated with long-term use of amiodarone. However, the committee highlighted that digoxin monotherapy in those with non-paroxysmal atrial fibrillation was not always limited to people that are sedentary and may also be considered in those with comorbidities or because of patient preferences that prevent the use of other rate control drugs. The reasoning given by the previous guideline committee to limit digoxin use in non-paroxysmal atrial fibrillation to those that are sedentary was due to concerns about reduced effectiveness during exercise. However, the current guideline committee agreed that there was not considered to be any evidence against considering digoxin in these additional groups and a number of committee members confirmed that from their experience digoxin was sometimes considered in those that were not sedentary if other options for monotherapy were not suitable. The committee were aware that some clinicians feel that digoxin monotherapy is often better than alternatives for improving symptoms; however, the lack of evidence currently available meant that the recommendation for digoxin was not expanded to cover further groups of people.

1.7.2. Cost effectiveness and resource use

No relevant health economic analyses were identified for this review. The unit costs of rate control drugs were presented. The unit costs are low and although there was limited clinical evidence, the committee felt that these costs were likely to be offset by the gains in quality of life. In discussion, the committee noted that the drugs considered are already in widespread use in current practice, and as such the cost impact of the recommendation is likely to be low. The committee considered other factors which may influence the resource use associated with any of the drugs. In particular, they discussed the serious adverse effects associated with the long-term use of amiodarone (including thyroid, lung and nerve damage), many of which are irreversible. The committee noted amiodarone requires intensive monitoring which has an associated cost. Furthermore, if a patient experiences these serious adverse events then there would be a significant cost to both the patient in terms of prognosis and NHS in terms of treatment and long-term management.

Due to the limited evidence available in the clinical review and lack of health economic evidence the committee decided to keep the existing recommendations, making only small amendments and additions. The consensus-based edits included cross referring to the chronic heart failure guideline, where the use of calcium channel blockers and beta blockers is not recommended in people with AF and concomitant heart failure. This is further supported by the acute heart failure guideline which advises caution when using beta blockers and that calcium channel blockers should not be used. This addition is not expected to have any resource impact on the NHS as this should already be current practice. The second amendment is expanding the population for whom digoxin monotherapy is considered to include those with comorbidities and/or patient preferences that rule out other rate-limiting drug options. The committee noted that this sometimes occurs in current practice and they do not anticipate this change in recommendation to have a significant resource impact to NHS resources.

1.7.2.1. Other factors the committee took into account

The committee was aware of a recently published study in recent-onset (acute) AF, which indicated that rate control with delayed cardioversion if AF did not resolve within 48 h was non-inferior to early cardioversion. This supports the use of rate control, with delayed cardioversion if required, as an appropriate treatment strategy in acute AF, meaning its inclusion as an option in the recommendations for acute AF rate control was considered to be appropriate.

References

1.
Al-Khatib SM, Lapointe NA, Chatterjee R, Crowley MJ, Dupre ME, Kong DF et al. Treatment of atrial fibrillation. Rockville (MD). Agency for Healthcare Research and Quality, 2013. Available from: https://www​.ncbi.nlm​.nih.gov/books/NBK153118​/pdf/Bookshelf_NBK153118.pdf [PubMed: 23905191]
2.
Alcalde RV, Guaragna JC, Bodanese LC, Castro I, Sussenbach E, Noer R et al. High dose of amiodarone in a short-term period reduces the incidence of postoperative atrial fibrillation and atrial flutter. Arquivos Brasileiros de Cardiologia. 2006; 87(3):236–240 [PubMed: 17057920]
3.
Andrivet P, Boubakri E, Dove PJ, Mach V, Vu Ngoc C. A clinical study of amiodarone as a single oral dose in patients with recent-onset atrial tachyarrhythmia. European Heart Journal. 1994; 15(10):1396–1402 [PubMed: 7821319]
4.
Anonymous. Intravenous digoxin in acute atrial fibrillation. Results of a randomized, placebo-controlled multicentre trial in 239 patients. The Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group. European Heart Journal. 1997; 18(4):649–654 [PubMed: 9129897]
5.
Aronow WS, Ferlinz J. Verapamil versus placebo in atrial fibrillation and atrial flutter. Clinical & Investigative Medicine. 1980; 3(1–2):35–39 [PubMed: 7009002]
6.
Aronow WS, Landa D, Plasencia G, Wong R, Karlsberg RP, Ferlinz J. Verapamil in atrial fibrillation and atrial flutter. Clinical Pharmacology and Therapeutics. 1979; 26(5):578–583 [PubMed: 498700]
7.
Aronow WS, Van Camp S, Turbow M, Whittaker K, Lurie M. Acebutolol in supraventricular arrhythmias. Clinical Pharmacology and Therapeutics. 1979; 25(2):149–153 [PubMed: 365429]
8.
Atwood JE, Myers J, Quaglietti S, Grumet J, Gianrossi R, Umman T. Effect of betaxolol on the hemodynamic, gas exchange, and cardiac output response to exercise in chronic atrial fibrillation. Chest. 1999; 115(4):1175–1180 [PubMed: 10208225]
9.
Balser JR, Martinez EA, Winters BD, Perdue PW, Clarke AW, Huang W et al. Beta-adrenergic blockade accelerates conversion of postoperative supraventricular tachyarrhythmias. Anesthesiology. 1998; 89(5):1052–1059 [PubMed: 9821992]
10.
Bavishi C, Khan AR, Ather S. Digoxin in patients with atrial fibrillation and heart failure: a meta-analysis. International Journal of Cardiology. 2015; 188(1):99–101 [PubMed: 25900519]
11.
Bellandi F, Dabizzi RP, Niccoli L, Cantini F. Propafenone and sotalol in the prevention of paroxysmal atrial fibrillation: long-term safety and efficacy study. Current Therapeutic Research - Clinical and Experimental. 1995; 56(11):1154–1168
12.
Bianconi L, Castro A, Dinelli M, Alboni P, Pappalardo A, Richiardi E et al. Comparison of intravenously administered dofetilide versus amiodarone in the acute termination of atrial fibrillation and flutter. A multicentre, randomized, double-blind, placebo-controlled study. European Heart Journal. 2000; 21(15):1265–1273 [PubMed: 10924317]
13.
Bianconi L, Mennuni M. Comparison between propafenone and digoxin administered intravenously to patients with acute atrial fibrillation. American Journal of Cardiology. 1998; 82(5):584–588 [PubMed: 9732884]
14.
Blevins RD, Kerin NZ, Benaderet D, Frumin H, Faitel K, Jarandilla R et al. Amiodarone in the management of refractory atrial fibrillation. Archives of Internal Medicine. 1987; 147(8):1401–1404 [PubMed: 3307669]
15.
BMJ Group and the Royal Pharmaceutical Society of Great Britain. British National Formulary. Available from: https://www​.evidence​.nhs.uk/formulary/bnf/current Last accessed: 21/01/2020.
16.
Bosi S, Coccolini S, Dalla Valle G, Guadagni C, Bellanti G, Graziani A. Paroxysmal atrial fibrillation: is prophylaxis always helpful? Current Therapeutic Research - Clinical and Experimental. 1990; 48(1):80–84
17.
Brodsky M, Saini R, Bellinger R, Zoble R, Weiss R, Powers L. Comparative effects of the combination of digoxin and dl-sotalol therapy versus digoxin monotherapy for control of ventricular response in chronic atrial fibrillation. American Heart Journal. 1994; 127(3):572–577 [PubMed: 8122604]
18.
Capucci A, Boriani G, Rubino I, Della Casa S, Sanguinetti M, Magnani B. A controlled study on oral propafenone versus digoxin plus quinidine in converting recent onset atrial fibrillation to sinus rhythm. International Journal of Cardiology. 1994; 43(3):305–313 [PubMed: 8181888]
19.
Chamaria S, Desai AM, Reddy PC, Olshansky B, Dominic P. Digoxin use to control ventricular rate in patients with atrial fibrillation and heart failure is not associated with increased mortality. Cardiology Research and Practice. 2015; 2015:1–10 [PMC free article: PMC4691628] [PubMed: 26788401]
20.
Cheiman DM, Shea BF, Kelly RA. Treatment of supraventricular tachyarrhythmias with intravenous calcium channel blockers: are subtle differences worth the cost? Pharmacotherapy. 1996; 16(5):861–868 [PubMed: 8888080]
21.
Chen K, Qin L, Lu X, Xia T, Gu Q. Amiodarone in the treatment of atrial fibrillation of patients with rheumatic heart disease after valve replacement. Pakistan Journal of Medical Sciences. 2019; 35(4):918–922 [PMC free article: PMC6659075] [PubMed: 31372117]
22.
Cheng JW, Rybak I. Use of digoxin for heart failure and atrial fibrillation in elderly patients. American Journal of Geriatric Pharmacotherapy. 2010; 8(5):419–427 [PubMed: 21335295]
23.
CIBIS Investigators and Committees. A randomized trial of beta-blockade in heart failure. The Cardiac Insufficiency Bisoprolol Study (CIBIS). CIBIS Investigators and Committees. Circulation. 1994; 90(4):1765–1773 [PubMed: 7923660]
24.
Cleland JG, Pennell DJ, Ray SG, Coats AJ, Macfarlane PW, Murray GD et al. Myocardial viability as a determinant of the ejection fraction response to carvedilol in patients with heart failure (CHRISTMAS trial): randomised controlled trial. Lancet. 2003; 362(9377):14–21 [PubMed: 12853194]
25.
Cochrane AD, Siddins M, Rosenfeldt FL, Salamonsen R, McConaghy L, Marasco S et al. A comparison of amiodarone and digoxin for treatment of supraventricular arrhythmias after cardiac surgery. European Journal of Cardio-Thoracic Surgery. 1994; 8(4):194–198 [PubMed: 8031562]
26.
Cotter G, Blatt A, Kaluski E, Metzkor-Cotter E, Koren M, Litinski I et al. Conversion of recent onset paroxysmal atrial fibrillation to normal sinus rhythm: the effect of no treatment and high-dose amiodarone. A randomized, placebo-controlled study. European Heart Journal. 1999; 20(24):1833–1842 [PubMed: 10581142]
27.
Cowan JC, Gardiner P, Reid DS, Newell DJ, Campbell RW. Amiodarone in the management of atrial fibrillation complicating myocardial infarction. British Journal of Clinical Practice Supplement. 1986; 44:155–163 [PubMed: 3089255]
28.
Cowan JC, Gardiner P, Reid DS, Newell DJ, Campbell RW. A comparison of amiodarone and digoxin in the treatment of atrial fibrillation complicating suspected acute myocardial infarction. Journal of Cardiovascular Pharmacology. 1986; 8(2):252–256 [PubMed: 2422461]
29.
Cybulski J, Kulakowski P, Makowska E, Czepiel A, Sikora-Frac M, Ceremuzynski L. Intravenous amiodarone is safe and seems to be effective in termination of paroxysmal supraventricular tachyarrhythmias. Clinical Cardiology. 1996; 19(7):563–566 [PubMed: 8818437]
30.
Dargie HJ. Effect of carvedilol on outcome after myocardial infarction in patients with left-ventricular dysfunction: the CAPRICORN randomised trial. Lancet. 2001; 357(9266):1385–1390 [PubMed: 11356434]
31.
Dargie HJL, P. The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet. 1999; 353(9146):9–13 [PubMed: 10023943]
32.
Daubert C, Mabo P, Gras D, Leclercq C. Clinical role of d-sotalol and d,l-sotalol in supraventricular arrhythmias, including pre-excitation. European Heart Journal. 1993; 14 (Suppl H):67–73 [PubMed: 7904939]
33.
Deedwania PC, Singh BN, Ellenbogen K, Fisher S, Fletcher R, Singh SN. Spontaneous conversion and maintenance of sinus rhythm by amiodarone in patients with heart failure and atrial fibrillation: observations from the veterans affairs congestive heart failure survival trial of antiarrhythmic therapy (CHF-STAT). The Department of Veterans Affairs CHF-STAT Investigators. Circulation. 1998; 98(23):2574–2579 [PubMed: 9843465]
34.
Delle Karth G, Geppert A, Neunteufl T, Priglinger U, Haumer M, Gschwandtner M et al. Amiodarone versus diltiazem for rate control in critically ill patients with atrial tachyarrhythmias. Critical Care Medicine. 2001; 29(6):1149–1153 [PubMed: 11395591]
35.
Demircan C, Cikriklar HI, Engindeniz Z, Cebicci H, Atar N, Guler V et al. Comparison of the effectiveness of intravenous diltiazem and metoprolol in the management of rapid ventricular rate in atrial fibrillation. Emergency Medicine Journal. 2005; 22(6):411–414 [PMC free article: PMC1726824] [PubMed: 15911947]
36.
Dias VC, Plumb VJ. Intravenous diltiazem in patients with atrial fibrillation/atrial flutter. A pilot dose-response study. Drug Investigation. 1991; 3(1):8–13
37.
Donovan KD, Power BM, Hockings BE, Dobb GJ, Lee KY. Intravenous flecainide versus amiodarone for recent-onset atrial fibrillation. American Journal of Cardiology. 1995; 75(10):693–697 [PubMed: 7900662]
38.
Dorian P, Paquette M, Newman D, Green M, Connolly SJ, Talajic M et al. Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation. American Heart Journal. 2002; 143(6):984–990 [PubMed: 12075253]
39.
Eichhorn EJ, Domanski MJ, Krause-Steinrauf H, Bristow MR, Lavori PW. A trial of the beta-blocker bucindolol in patients with advanced chronic heart failure. New England Journal of Medicine. 2001; 344(22):1659–1667 [PubMed: 11386264]
40.
Ellenbogen KA, Dias VC, Cardello FP, Strauss WE, Simonton CA, Pollak SJ et al. Safety and efficacy of intravenous diltiazem in atrial fibrillation or atrial flutter. American Journal of Cardiology. 1995; 75(1):45–49 [PubMed: 7801862]
41.
Ellenbogen KA, Dias VC, Plumb VJ, Heywood JT, Mirvis DM. A placebo-controlled trial of continuous intravenous diltiazem infusion for 24-hour heart rate control during atrial fibrillation and atrial flutter: a multicenter study. Journal of the American College of Cardiology. 1991; 18(4):891–897 [PubMed: 1894861]
42.
Falk RH, Knowlton AA. Is digoxin necessary in converting recent-onset atrial fibrillation? Cardiology Board Review. 1987; 4(11):99–105
43.
Falk RH, Knowlton AA, Bernard SA, Gotlieb NE, Battinelli NJ. Digoxin for converting recent-onset atrial fibrillation to sinus rhythm. A randomized, double-blinded trial. Annals of Internal Medicine. 1987; 106(4):503–506 [PubMed: 3548521]
44.
Fauchier L, Grimard C, Pierre B, Nonin E, Gorin L, Rauzy B et al. Comparison of beta blocker and digoxin alone and in combination for management of patients with atrial fibrillation and heart failure. American Journal of Cardiology. 2009; 103(2):248–254 [PubMed: 19121446]
45.
Flaker G, Lopes RD, Hylek E, Wojdyla DM, Thomas L, Al-Khatib SM et al. Amiodarone, anticoagulation, and clinical events in patients with atrial fibrillation: Insights from the ARISTOTLE trial. Journal of the American College of Cardiology. 2014; 64(15):1541–1550 [PubMed: 25301455]
46.
Flather MD, Shibata MC, Coats AJ, Van Veldhuisen DJ, Parkhomenko A, Borbola J et al. Randomized trial to determine the effect of nebivolol on mortality and cardiovascular hospital admission in elderly patients with heart failure (SENIORS). European Heart Journal. 2005; 26(3):215–225 [PubMed: 15642700]
47.
Freemantle N, Lafuente-Lafuente C, Mitchell S, Eckert L, Reynolds M. Mixed treatment comparison of dronedarone, amiodarone, sotalol, flecainide, and propafenone, for the management of atrial fibrillation. Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology. 2011; 13(3):329–345 [PubMed: 21227948]
48.
Fromm C, Suau SJ, Cohen V, Likourezos A, Jellinek-Cohen S, Rose J et al. Diltiazem vs. metoprolol in the management of atrial fibrillation or flutter with rapid ventricular rate in the emergency department. Journal of Emergency Medicine. 2015; 49(2):175–182 [PubMed: 25913166]
49.
Gallik DM, Kim SG, Ferrick KJ, Roth JA, Fisher JD. Efficacy and safety of sotalol in patients with refractory atrial fibrillation or flutter. American Heart Journal. 1997; 134(2 Pt 1):155–160 [PubMed: 9313591]
50.
Galve E, Rius T, Ballester R, Artaza MA, Arnau JM, Garcia-Dorado D et al. Intravenous amiodarone in treatment of recent-onset atrial fibrillation: results of a randomized, controlled study. Journal of the American College of Cardiology. 1996; 27(5):1079–1082 [PubMed: 8609324]
51.
Goldenberg IF, Lewis WR, Dias VC, Heywood JT, Pedersen WR. Intravenous diltiazem for the treatment of patients with atrial fibrillation or flutter and moderate to severe congestive heart failure. American Journal of Cardiology. 1994; 74(9):884–889 [PubMed: 7977118]
52.
Gonzalez R, Scheinman MM. Treatment of supraventricular arrhythmias with intravenous and oral verapamil. Chest. 1981; 80(4):465–470 [PubMed: 7023864]
53.
Hassan S, Slim AM, Kamalakannan D, Khoury R, Kakish E, Maria V et al. Conversion of atrial fibrillation to sinus rhythm during treatment with intravenous esmolol or diltiazem: a prospective, randomized comparison. Journal of Cardiovascular Pharmacology and Therapeutics. 2007; 12(3):227–231 [PubMed: 17875950]
54.
Hemels ME, Van Noord T, Crijns HJ, Van Veldhuisen DJ, Veeger NJ, Bosker HA et al. Verapamil versus digoxin and acute versus routine serial cardioversion for the improvement of rhythm control for persistent atrial fibrillation. Journal of the American College of Cardiology. 2006; 48(5):1001–1009 [PubMed: 16949494]
55.
Heywood JT. Calcium channel blockers for heart rate control in atrial fibrillation complicated by congestive heart failure. Canadian Journal of Cardiology. 1995; 11(9):823–826 [PubMed: 7585281]
56.
Hjalmarson A. Arrhythmias. American Journal of Cardiology. 1985; 56(14):35G–38G [PubMed: 3904392]
57.
Hofmann R, Steinwender C, Kammler J, Kypta A, Leisch F. Effects of a high dose intravenous bolus amiodarone in patients with atrial fibrillation and a rapid ventricular rate. International Journal of Cardiology. 2006; 110(1):27–32 [PubMed: 16046015]
58.
Hornestam B, Held P, Edvardsson N. Effects of digoxin on electrocardiogram in patients with acute atrial fibrillation--a randomized, placebo-controlled study. Digitalis in Acute Atrial Fibrillation (DAAF) Trial Group. Clinical Cardiology. 1999; 22(2):96–102 [PMC free article: PMC6656138] [PubMed: 10068846]
59.
Hou ZY, Chang MS, Chen CY, Tu MS, Lin SL, Chiang HT et al. Acute treatment of recent-onset atrial fibrillation and flutter with a tailored dosing regimen of intravenous amiodarone. A randomized, digoxin-controlled study. European Heart Journal. 1995; 16(4):521–528 [PubMed: 7671898]
60.
Ibrahim I, Kuan WS, Yau YW, Chua MT, Lin Z, Cheng L et al. Different rate-controlling agents for the management of atrial fibrillation with rapid ventricular rate in the emergency department: a network meta-analysis. Cochrane Database of Systematic Reviews 2020, Issue 6. Art. No.: CD013642. DOI: 10.1002/14651858.CD013642. [CrossRef]
61.
Inoue H, Atarashi H, Okumura K, Yamashita T, Fukuzawa M, Shiosakai K et al. Heart rate control by carvedilol in Japanese patients with chronic atrial fibrillation: The AF Carvedilol study. Journal of Cardiology. 2017; 69(1):293–301 [PubMed: 27364549]
62.
Jafri SH, Cerecedo-Lopez CD, Warsi AI, Xu J. Diltiazem versus metoprolol for the management of atrial fibrillation: A systematic review and meta-analysis. Journal of the American College of Cardiology. 2020; 75(11):436
63.
Joglar JA, Acusta AP, Shusterman NH, Ramaswamy K, Kowal RC, Barbera SJ et al. Effect of carvedilol on survival and hemodynamics in patients with atrial fibrillation and left ventricular dysfunction: retrospective analysis of the US Carvedilol Heart Failure Trials Program. American Heart Journal. 2001; 142(3):498–501 [PubMed: 11526364]
64.
Jordaens L, Trouerbach J, Calle P, Tavernier R, Derycke E, Vertongen P et al. Conversion of atrial fibrillation to sinus rhythm and rate control by digoxin in comparison to placebo. European Heart Journal. 1997; 18(4):643–648 [PubMed: 9129896]
65.
Joseph AP, Ward MR. A prospective, randomized controlled trial comparing the efficacy and safety of sotalol, amiodarone, and digoxin for the reversion of new-onset atrial fibrillation. Annals of Emergency Medicine. 2000; 36(1):1–9 [PubMed: 10874228]
66.
Kakihana Y, Nishida O, Taniguchi T, Okajima M, Morimatsu H, Ogura H et al. Efficacy and safety of landiolol, an ultra-short-acting beta1-selective antagonist, for treatment of sepsis-related tachyarrhythmia (J-Land 3S): a multicentre, open-label, randomised controlled trial. The Lancet Respiratory Medicine. 2020; 8(9):863–872 [PubMed: 32243865]
67.
Kamali A, Sanatkar A, Sharifi M, Moshir E. Evaluation of amiodarone versus metoprolol in treating atrial fibrillation after coronary artery bypass grafting. Interventional Medicine and Applied Science. 2017; 9(2):51–55 [PMC free article: PMC5598126] [PubMed: 28932497]
68.
Kanji S, Stewart R, Fergusson DA, McIntyre L, Turgeon AF, Hebert PC. Treatment of new-onset atrial fibrillation in noncardiac intensive care unit patients: a systematic review of randomized controlled trials. Critical Care Medicine. 2008; 36(5):1620–1624 [PubMed: 18434899]
69.
Kao DP, Davis G, Aleong R, O’Connor CM, Fiuzat M, Carson PE et al. Effect of bucindolol on heart failure outcomes and heart rate response in patients with reduced ejection fraction heart failure and atrial fibrillation. European Journal of Heart Failure. 2013; 15(3):324–333 [PMC free article: PMC3576901] [PubMed: 23223178]
70.
Karaca I, Coskun N, Yavuzkir M, Iikay E, Dagli N, Isik A et al. Effect of diltiazen and metoprolol on left atrial appendix functions in patients with nonvalvular chronic atrial fibrillation. Anadolu Kardiyoloji Dergisi. 2007; 7(1):37–41 [PubMed: 17347074]
71.
Kettering K, Gramley F. Catheter ablation of persistent atrial fibrillation : Beneficial effect of a short-term adjunctive amiodarone therapy on the long-term outcome. Herzschrittmachertherapie und elektrophysiologie. 2018; 29(1):133–140 [PubMed: 28447159]
72.
Khairy P, Roy D. Atrial fibrillation: Challenging the status quo: beta-blockers for HF plus AF. Nature Reviews Cardiology. 2014; 11(12):690–692 [PubMed: 25311227]
73.
Khan SS, Gheorghiade M. Digoxin use in atrial fibrillation: a critical reappraisal. Lancet. 2015; 385(9985):2330–2332 [PubMed: 25749645]
74.
Khand AU, Chew PG, Douglas H, Jones J, Jan A, Cleland JG. The effect of carvedilol on B-type natriuretic peptide and cardiac function in patients with heart failure and persistent atrial fibrillation. Cardiology. 2015; 130(3):153–158 [PubMed: 25660493]
75.
Khand AU, Rankin AC, Kaye GC, Cleland JG. Systematic review of the management of atrial fibrillation in patients with heart failure. European Heart Journal. 2000; 21(8):614–632 [PubMed: 10731399]
76.
Khand AU, Rankin AC, Martin W, Taylor J, Gemmell I, Cleland JG. Carvedilol alone or in combination with digoxin for the management of atrial fibrillation in patients with heart failure? Journal of the American College of Cardiology. 2003; 42(11):1944–1951 [PubMed: 14662257]
77.
Klein G, Wirtzfeld A, Alt E, Steck J, Saunders R, Hulse J et al. Antiarrhythmic activity of esmolol (ASL-8052)--a novel ultra-short acting beta-adrenoreceptor blocking agent. International Journal of Clinical Pharmacology, Therapy, and Toxicology. 1984; 22(2):112–117 [PubMed: 6142005]
78.
Kochiadakis GE, Igoumenidis NE, Marketou ME, Kaleboubas MD, Simantirakis EN, Vardas PE. Low dose amiodarone and sotalol in the treatment of recurrent, symptomatic atrial fibrillation: a comparative, placebo controlled study. Heart. 2000; 84(3):251–257 [PMC free article: PMC1760955] [PubMed: 10956284]
79.
Kochiadakis GE, Igoumenidis NE, Marketou ME, Solomou MC, Kanoupakis EM, Vardas PE. Low-dose amiodarone versus sotalol for suppression of recurrent symptomatic atrial fibrillation. American Journal of Cardiology. 1998; 81(8):995–998 [PubMed: 9576159]
80.
Kochiadakis GE, Kanoupakis EM, Igoumenidis NE, Mavrakis HE, Kafarakis PK, Vardas PE. Efficacy and safety of oral amiodarone in controlling heart rate in patients with persistent atrial fibrillation who have undergone digitalisation. Hellenic Journal of Cardiology. 2005; 46(5):336–340 [PubMed: 16295942]
81.
Koh KK, Kwon KS, Park HB, Baik SH, Park SJ, Lee KH et al. Efficacy and safety of digoxin alone and in combination with low-dose diltiazem or betaxolol to control ventricular rate in chronic atrial fibrillation. American Journal of Cardiology. 1995; 75(1):88–90 [PubMed: 7801876]
82.
Kolokotroni SM, Toufektzian L, Harling L, Bille A. In patients undergoing lung resection is it safe to administer amiodarone either as prophylaxis or treatment of atrial fibrillation? Interactive Cardiovascular and Thoracic Surgery. 2017; 24(5):783–788 [PubMed: 28453809]
83.
Kotecha D, Calvert M, Deeks JJ, Griffith M, Kirchhof P, Lip GY et al. A review of rate control in atrial fibrillation, and the rationale and protocol for the RATE-AF trial. BMJ Open. 2017; 7(7):e015099 [PMC free article: PMC5588987] [PubMed: 28729311]
84.
Kotecha D, Holmes J, Krum H, Altman DG, Manzano L, Cleland JG et al. Efficacy of beta blockers in patients with heart failure plus atrial fibrillation: an individual-patient data meta-analysis. Lancet. 2014; 384(9961):2235–2243 [PubMed: 25193873]
85.
Lane DA, Boos CJ, Lip GY. Atrial fibrillation (chronic). BMJ Clinical Evidence. 2015; 2015:217
86.
Lang R, Klein HO, Weiss E, David D, Sareli P, Levy A et al. Superiority of oral verapamil therapy to digoxin in treatment of chronic atrial fibrillation. Chest. 1983; 83(3):491–499 [PubMed: 6337787]
87.
Lechat P, Hulot JS, Escolano S, Mallet A, Leizorovicz A, Werhlen-Grandjean M et al. Heart rate and cardiac rhythm relationships with bisoprolol benefit in chronic heart failure in CIBIS II Trial. Circulation. 2001; 103(10):1428–1433 [PubMed: 11245648]
88.
Lip GY, Apostolakis S. Atrial fibrillation (acute onset). BMJ Clinical Evidence. 2014; 2014:0210 [PMC free article: PMC4246362] [PubMed: 25430048]
89.
Lombardi F, Borggrefe M, Ruzyllo W, Luderitz B. Azimilide vs. placebo and sotalol for persistent atrial fibrillation: The A-COMET-II (Azimilide-CardiOversion MaintEnance Trial-II) trial. European Heart Journal. 2006; 27(18):2224–2231 [PubMed: 16935870]
90.
Lumer GB, Roy D, Talajic M, Couturier A, Lambert J, Frasure-Smith N et al. Amiodarone reduces procedures and costs related to atrial fibrillation in a controlled clinical trial. European Heart Journal. 2002; 23(13):1050–1056 [PubMed: 12093058]
91.
Lundstrom T, Ryden L. Ventricular rate control and exercise performance in chronic atrial fibrillation: effects of diltiazem and verapamil. Journal of the American College of Cardiology. 1990; 16(1):86–90 [PubMed: 2358610]
92.
MacMahon SS, N;Doughty, R. Randomised, placebo-controlled trial of carvedilol in patients with congestive heart failure due to ischaemic heart disease. Australia/New Zealand Heart Failure Research Collaborative Group. Lancet. 1997; 349(9049):375–380 [PubMed: 9033462]
93.
Maragno I, Santostasi G, Gaion RM, Trento M, Grion AM, Miraglia G et al. Low- and medium-dose diltiazem in chronic atrial fibrillation: comparison with digoxin and correlation with drug plasma levels. American Heart Journal. 1988; 116(2 Pt 1):385–392 [PubMed: 3400564]
94.
Mareev Y, Cleland JG. Should beta-blockers be used in patients with heart failure and atrial fibrillation? Clinical Therapeutics. 2015; 37(10):2215–2224 [PubMed: 26391145]
95.
Martindale JL, deSouza IS, Silverberg M, Freedman J, Sinert R. Beta-blockers versus calcium channel blockers for acute rate control of atrial fibrillation with rapid ventricular response: a systematic review. European Journal of Emergency Medicine. 2015; 22(3):150–154 [PubMed: 25564459]
96.
McMurray J, Kober L, Robertson M, Dargie H, Colucci W, Lopez-Sendon J et al. Antiarrhythmic effect of carvedilol after acute myocardial infarction: results of the Carvedilol Post-Infarct Survival Control in Left Ventricular Dysfunction (CAPRICORN) trial. Journal of the American College of Cardiology. 2005; 45(4):525–530 [PubMed: 15708698]
97.
McNamara RL, Tamariz LJ, Segal JB, Bass EB. Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Annals of Internal Medicine. 2003; 139(12):1018–1033 [PubMed: 14678922]
98.
MERIT-HF Study Group. Effect of metoprolol CR/XL in chronic heart failure: Metoprolol CR/XL Randomised Intervention Trial in Congestive Heart Failure (MERIT-HF). Lancet. 1999; 353(9169):2001–2007 [PubMed: 10376614]
99.
Moghadam MA, Dashti MF, Shahsavarinia K, Mahmoodpoor A, Jamali K. A comparison of verapamil and digoxin for heart rate control in atrial fibrillation. Advanced Pharmaceutical Bulletin. 2012; 2(2):201–205 [PMC free article: PMC3846001] [PubMed: 24312794]
100.
Mooss AN, Wurdeman RL, Mohiuddin SM, Reyes AP, Sugimoto JT, Scott W et al. Esmolol versus diltiazem in the treatment of postoperative atrial fibrillation/atrial flutter after open heart surgery. American Heart Journal. 2000; 140(1):176–180 [PubMed: 10874282]
101.
Mount KL, Pickworth KK. Intravenous amiodarone for the treatment of atrial fibrillation in the nonsurgical patient. Journal of Pharmacy Practice. 2002; 15(4):356–368
102.
Mulder BA, van Veldhuisen DJ, Crijns HJ, Bohm M, Cohen-Solal A, Babalis D et al. Effect of nebivolol on outcome in elderly patients with heart failure and atrial fibrillation: insights from SENIORS. European Journal of Heart Failure. 2012; 14(10):1171–1178 [PubMed: 22764183]
103.
National Institute for Health and Care Excellence. Developing NICE guidelines: the manual [Updated October 2018]. London. National Institute for Health and Care Excellence, 2014. Available from: https://www​.nice.org​.uk/process/pmg20/chapter​/introduction-and-overview [PubMed: 26677490]
104.
Nikolaidou T, Channer KS. Chronic atrial fibrillation: a systematic review of medical heart rate control management. Postgraduate Medical Journal. 2009; 85(1004):303–312 [PubMed: 19528305]
105.
Noble SL, Replogle WH, Dickey SR. Amiodarone for the treatment of persistent atrial fibrillation. Journal of Family Practice. 1999; 48(5):334–335 [PubMed: 10334605]
106.
Noc M, Stajer D, Horvat M. Intravenous amiodarone versus verapamil for acute conversion of paroxysmal atrial fibrillation to sinus rhythm. American Journal of Cardiology. 1990; 65(9):679–680 [PubMed: 2178386]
107.
O’Bryan LJ, Redfern OC, Bedford J, Petrinic T, Young JD, Watkinson PJ. Managing new-onset atrial fibrillation in critically ill patients: a systematic narrative review. BMJ Open. 2020; 10(3):e034774 [PMC free article: PMC7202704] [PubMed: 32209631]
108.
Ochs HR, Anda L, Eichelbaum M, Greenblatt DJ. Diltiazem, verapamil, and quinidine in patients with chronic atrial fibrillation. Journal of Clinical Pharmacology. 1985; 25(3):204–209 [PubMed: 3889076]
109.
Packer M, Bristow MR, Cohn JN, Colucci WS, Fowler MB, Gilbert EM et al. The effect of carvedilol on morbidity and mortality in patients with chronic heart failure. U.S. Carvedilol Heart Failure Study Group. New England Journal of Medicine. 1996; 334(21):1349–1355 [PubMed: 8614419]
110.
Packer M, Coats AJ, Fowler MB, Katus HA, Krum H, Mohacsi P et al. Effect of carvedilol on survival in severe chronic heart failure. New England Journal of Medicine. 2001; 344(22):1651–1658 [PubMed: 11386263]
111.
Pan J, Wang W, Wu X, Kong F, Pan J, Lin J et al. Inflammatory cytokines in cardiac pacing patients with atrial fibrillation and asymptomatic atrial fibrillation. Panminerva Medica. 2018; 60(3):86–91 [PubMed: 29696963]
112.
Patten M, Maas R, Karim A, Muller HW, Simonovsky R, Meinertz T. Event-recorder monitoring in the diagnosis of atrial fibrillation in symptomatic patients: subanalysis of the SOPAT trial. Journal of Cardiovascular Electrophysiology. 2006; 17(11):1216–1220 [PubMed: 16987384]
113.
Peuhkurinen K, Niemela M, Ylitalo A, Linnaluoto M, Lilja M, Juvonen J. Effectiveness of amiodarone as a single oral dose for recent-onset atrial fibrillation. American Journal of Cardiology. 2000; 85(4):462–465 [PubMed: 10728951]
114.
Pinter A, Dorian P, Paquette M, Ng A, Burns M, Spanu I et al. Left ventricular performance during acute rate control in atrial fibrillation: the importance of heart rate and agent used. Journal of Cardiovascular Pharmacology and Therapeutics. 2003; 8(1):17–24 [PubMed: 12652326]
115.
Platia EV, Michelson EL, Porterfield JK, Das G. Esmolol versus verapamil in the acute treatment of atrial fibrillation or atrial flutter. American Journal of Cardiology. 1989; 63(13):925–929 [PubMed: 2564725]
116.
Plumb VJ, Karp RB, Kouchoukos NT, Zorn GL, Jr., James TN, Waldo AL. Verapamil therapy of atrial fibrillation and atrial flutter following cardiac operation. The Journal of thoracic and cardiovascular surgery. 1982; 83(4):590–596 [PubMed: 7038316]
117.
Pluymaekers N, Dudink E, Luermans J, Meeder JG, Lenderink T, Widdershoven J et al. Early or delayed cardioversion in recent-onset atrial fibrillation. New England Journal of Medicine. 2019; 380(16):1499–1508 [PubMed: 30883054]
118.
Qureshi W, O’Neal WT, Soliman EZ, Al-Mallah MH. Systematic review and meta-analysis of mortality and digoxin use in atrial fibrillation. Cardiology Journal. 2016; 23(3):333–343 [PubMed: 27064796]
119.
Redfors A. Digoxin dosage and ventricular rate at rest and exercise in patients with atrial fibrillation. Acta Medica Scandinavica. 1971; 190(4):321–333 [PubMed: 5124263]
120.
Redfors A. The effect of different digoxin doses on subjective symptoms and physical working capacity in patients with atrial fibrillation. Acta Medica Scandinavica. 1971; 190(4):307–320 [PubMed: 5124262]
121.
Rehnqvist N. Clinical experience with intravenous metoprolol in supraventricular tachyarrhythmias. A multicentre study. Annals of Clinical Research. 1981; 13(Suppl 30):68–72 [PubMed: 7027895]
122.
Reynolds MR, Ellis E, Zimetbaum P. Quality of life in atrial fibrillation: measurement tools and impact of interventions. Journal of Cardiovascular Electrophysiology. 2008; 19(7):762–768 [PMC free article: PMC2574796] [PubMed: 18266667]
123.
Ribeiro LG, Kasdin SL, Snyder DL, Fisher MB, Irvin JD. Beneficial effects of timolol in digitalized patients with atrial fibrillation and a rapid ventricular response. Arquivos Brasileiros de Cardiologia. 1986; 46(3):211–215 [PubMed: 3548664]
124.
Rienstra M, Damman K, Mulder BA, Van Gelder IC, McMurray JJV, Van Veldhuisen DJ. Beta-blockers and outcome in heart failure and atrial fibrillation. A meta-analysis. JACC: Heart Failure. 2013; 1(1):21–28 [PubMed: 24621795]
125.
Roth A, Harrison E, Mitani G. Efficacy and safety of medium- and high-dose diltiazem alone and in combination with digoxin for control of heart-rate at rest and during exercise in patients with chronic atrial fibrillation. Circulation. 1986; 73(2):316–324 [PubMed: 3943166]
126.
Roy D, Talajic M, Dorian P, Connolly S, Eisenberg MJ, Green M et al. Amiodarone to prevent recurrence of atrial fibrillation. New England Journal of Medicine. 2000; 342(13):913–920 [PubMed: 10738049]
127.
Roy D, Talajic M, Thibault B, Dubuc M, Nattel S, Eisenberg MJ et al. Pilot study and protocol of the Canadian Trial of Atrial Fibrillation (CTAF). American Journal of Cardiology. 1997; 80(4):464–468 [PubMed: 9285659]
128.
Salerno DM, Dias VC, Kleiger RE, Tschida VH, Sung RJ, Sami M et al. Efficacy and safety of intravenous diltiazem for treatment of atrial fibrillation and atrial flutter. American Journal of Cardiology. 1989; 63(15):1046–1051 [PubMed: 2650517]
129.
Sandberg F, Corino VD, Mainardi LT, Ulimoen SR, Enger S, Tveit A et al. Non-invasive assessment of the effect of beta blockers and calcium channel blockers on the AV node during permanent atrial fibrillation. Journal of Electrocardiology. 2015; 48(5):861–866 [PubMed: 26275982]
130.
Santangeli P, Di Biase L, Burkhardt JD, Bai R, Mohanty P, Pump A et al. Examining the safety of amiodarone. Expert Opinion on Drug Safety. 2012; 11(2):191–214 [PubMed: 22324910]
131.
Schreck DM, Rivera AR, Tricarico VJ. Emergency management of atrial fibrillation and flutter: intravenous diltiazem versus intravenous digoxin. Annals of Emergency Medicine. 1997; 29(1):135–140 [PubMed: 8998092]
132.
Segal JB, McNamara RL, Miller MR, Kim N, Goodman SN, Powe NR et al. The evidence regarding the drugs used for ventricular rate control. Journal of Family Practice. 2000; 49(1):47–59 [PubMed: 10678340]
133.
Sethi NJ, Nielsen EE, Safi S, Feinberg J, Gluud C, Jakobsen JC. Digoxin for atrial fibrillation and atrial flutter: A systematic review with meta-analysis and trial sequential analysis of randomised clinical trials. PloS One. 2018; 13(3):e0193924 [PMC free article: PMC5843263] [PubMed: 29518134]
134.
Sethi NJ, Safi S, Feinberg J, Nielsen EE, Gluud C, Jakobsen JC. Digoxin versus placebo, no intervention, or other medical interventions for atrial fibrillation and atrial flutter: a protocol for a systematic review with meta-analysis and Trial Sequential Analysis. Systematic Reviews. 2017; 6(1):71 [PMC free article: PMC5382469] [PubMed: 28381269]
135.
Shojaee M, Feizi B, Miri R, Etemadi J, Feizi AH. Intravenous amiodarone versus digoxin in atrial fibrillation rate control; a clinical trial. Emergency. 2017; 5(1):e29 [PMC free article: PMC5325898] [PubMed: 28286836]
136.
Shu M, Xi R, Zhang P, He G, Song Z, Chi L et al. Short-term and long-term effects of bisoprolol on chronic heart failure related to rheumatic heart disease and atrial fibrillation. P and T. 2005; 30(7):400–407
137.
Simpson CS, Ghali WA, Sanfilippo AJ, Moritz S, Abdollah H. Clinical assessment of clonidine in the treatment of new-onset rapid atrial fibrillation: a prospective, randomized clinical trial. American Heart Journal. 2001; 142(2):E3 [PubMed: 11479482]
138.
Singh S, Saini RK, DiMarco J, Kluger J, Gold R, Chen YW. Efficacy and safety of sotalol in digitalized patients with chronic atrial fibrillation. The Sotalol Study Group. American Journal of Cardiology. 1991; 68(11):1227–1230 [PubMed: 1951086]
139.
Singh SN, Singh BN, Reda DJ, Fye CL, Ezekowitz MD, Fletcher RD et al. Comparison of sotalol versus amiodarone in maintaining stability of sinus rhythm in patients with atrial fibrillation (Sotalol-Amiodarone Fibrillation Efficacy Trial ). American Journal of Cardiology. 2003; 92(4):468–472 [PubMed: 12914883]
140.
Siu CW, Lau CP, Lee WL, Lam KF, Tse HF. Intravenous diltiazem is superior to intravenous amiodarone or digoxin for achieving ventricular rate control in patients with acute uncomplicated atrial fibrillation. Critical Care Medicine. 2009; 37(7):2174–2180 [PubMed: 19487941]
141.
Stern EH, Pitchon R, King BD, Guerrero J, Schneider RR, Wiener I. Clinical use of oral verapamil in chronic and paroxysmal atrial fibrillation. Chest. 1982; 81(3):308–311 [PubMed: 7056105]
142.
Sticherling C, Hsu W, Tada H, Bares AC, Oral H, Pelosi F et al. Effects of verapamil and ibutilide on atrial fibrillation and postfibrillation atrial refractoriness. Journal of Cardiovascular Electrophysiology. 2002; 13(2):151–157 [PubMed: 11900290]
143.
Sticherling C, Tada H, Hsu W, Bares AC, Oral H, Pelosi F et al. Effects of diltiazem and esmolol on cycle length and spontaneous conversion of atrial fibrillation. Journal of Cardiovascular Pharmacology and Therapeutics. 2002; 7(2):81–88 [PubMed: 12075396]
144.
Sullivan SD, Orme ME, Morais E, Mitchell SA. Interventions for the treatment of atrial fibrillation: a systematic literature review and meta-analysis. International Journal of Cardiology. 2013; 165(2):229–236 [PubMed: 22469557]
145.
Sung RJ, Tan HL, Karagounis L, Hanyok JJ, Falk R, Platia E et al. Intravenous sotalol for the termination of supraventricular tachycardia and atrial fibrillation and flutter: a multicenter, randomized, double-blind, placebo-controlled study. Sotalol Multicenter Study Group. American Heart Journal. 1995; 129(4):739–748 [PubMed: 7900626]
146.
Sung RJ, Waxman HL, Elser B, Juma Z. Treatment of paroxysmal supraventricular tachycardia and atrial flutter-fibrillation with intravenous verapamil: efficacy and mechanism of action. Clinical & Investigative Medicine. 1980; 3(1–2):41–47 [PubMed: 7009003]
147.
Sweany AE, Moncloa F, Vickers FF, Zupkis RV. Antiarrhythmic effects of intravenous timolol in supraventricular arrhythmias. Clinical Pharmacology and Therapeutics. 1985; 37(2):124–127 [PubMed: 3881206]
148.
Thomas SP, Guy D, Wallace E, Crampton R, Kijvanit P, Eipper V et al. Rapid loading of sotalol or amiodarone for management of recent onset symptomatic atrial fibrillation: a randomized, digoxin-controlled trial. American Heart Journal. 2004; 147(1):E3 [PubMed: 14691441]
149.
Tisdale JE, Padhi ID, Goldberg AD, Silverman NA, Webb CR, Higgins RS et al. A randomized, double-blind comparison of intravenous diltiazem and digoxin for atrial fibrillation after coronary artery bypass surgery. American Heart Journal. 1998; 135(5 Pt 1):739–747 [PubMed: 9588402]
150.
Tommaso C, McDonough T, Parker M, Talano JV. Atrial fibrillation and flutter. immediate control and conversion with intravenously administered verapamil. Archives of Internal Medicine. 1983; 143(5):877–881 [PubMed: 6679229]
151.
Tse HF, Lam YM, Lau CP, Cheung BM, Kumana CR. Comparison of digoxin versus low-dose amiodarone for ventricular rate control in patients with chronic atrial fibrillation. Clinical and Experimental Pharmacology and Physiology. 2001; 28(5–6):446–450 [PubMed: 11380520]
152.
Tse HF, Lau CP, Wang Q, Pelosi F, Oral H, Knight BP et al. Effect of diltiazem on the recurrence rate of paroxysmal atrial fibrillation. American Journal of Cardiology. 2001; 88(5):568–570 [PubMed: 11524073]
153.
Tsuneda T, Yamashita T, Fukunami M, Kumagai K, Niwano S, Okumura K et al. Rate control and quality of life in patients with permanent atrial fibrillation: the Quality of Life and Atrial Fibrillation (QOLAF) Study. Circulation Journal. 2006; 70(8):965–970 [PubMed: 16864926]
154.
Vamos M, Erath JW, Benz AP, Lopes RD, Hohnloser SH. Meta-analysis of effects of digoxin on survival in patients with atrial fibrillation or heart failure: an update. American Journal of Cardiology. 2019; 123(1):69–74 [PubMed: 30539748]
155.
Vamos M, Erath JW, Hohnloser SH. Digoxin-associated mortality: a systematic review and meta-analysis of the literature. European Heart Journal. 2015; 36(28):1831–1838 [PubMed: 25939649]
156.
Veloso HH, de Paola AAV, Olshansky B, Rosenfeld LE, Warner AL, Solomon AJ. Beta-blockers versus digoxin to control ventricular rate during atrial fibrillation. Journal of the American College of Cardiology. 2005; 45(11):1905–1907 [PubMed: 15936626]
157.
Veloso HH, Joseph AP. Comparison of class III antiarrhythmic drugs versus digoxin for the reversion of new-onset atrial fibrillation. Annals of Emergency Medicine. 2001; 37(6):735–736 [PubMed: 11385352]
158.
Waagstein F, Bristow MR, Swedberg K, Camerini F, Fowler MB, Silver MA et al. Beneficial effects of metoprolol in idiopathic dilated cardiomyopathy. Metoprolol in Dilated Cardiomyopathy (MDC) Trial Study Group. Lancet. 1993; 342(8885):1441–1446 [PubMed: 7902479]
159.
Wang L, Liu Q, Ma X. Impact of amiodarone on cardiac structural function and mmp-2 and timp-2 levels in atrial fibrillation radiofrequency ablation. International Journal of Clinical and Experimental Medicine. 2019; 12(4):4287–4293
160.
Wang ZQ, Zhang R, Chen MT, Wang QS, Zhang Y, Huang XH et al. Digoxin is associated with increased all-cause mortality in patients with atrial fibrillation regardless of concomitant heart failure: a meta-analysis. Journal of Cardiovascular Pharmacology. 2015; 66(3):270–275 [PubMed: 26348825]
161.
Wanless RS, Anderson K, Joy M, Joseph SP. Multicenter comparative study of the efficacy and safety of sotalol in the prophylactic treatment of patients with paroxysmal supraventricular tachyarrhythmias. American Heart Journal. 1997; 133(4):441–446 [PubMed: 9124166]
162.
Wasir HS, Mahapatra RK, Bhatia ML, Roy SB, Sannerstedt R. Metoprolol--a new cardioselective beta-adrenoceptor blocking agent for treatment of tachyarrhythmias. British Heart Journal. 1977; 39(8):834–838 [PMC free article: PMC483327] [PubMed: 901674]
163.
Wattanasuwan N, Khan IA, Mehta NJ, Arora P, Singh N, Vasavada BC et al. Acute ventricular rate control in atrial fibrillation: IV combination of diltiazem and digoxin vs. IV diltiazem alone. Chest. 2001; 119(2):502–506 [PubMed: 11171729]
164.
Williams DO, Tatelbaum R, Most AS. Effective treatment of supraventricular arrhythmias with acebutolol. American Journal of Cardiology. 1979; 44(3):521–525 [PubMed: 382821]
165.
Xu T, Huang Y, Zhou H, Bai Y, Huang X, Hu Y et al. Beta-blockers and risk of all-cause mortality in patients with chronic heart failure and atrial fibrillation-a meta-analysis. BMC Cardiovascular Disorders. 2019; 19(1):135 [PMC free article: PMC6547467] [PubMed: 31159740]
166.
Ziff OJ, Samra M, Howard JP, Bromage DI, Ruschitzka F, Francis DP et al. Beta-blocker efficacy across different cardiovascular indications: an umbrella review and meta-analytic assessment. BMC Medicine. 2020; 18(1):103 [PMC free article: PMC7199339] [PubMed: 32366251]
167.
Zoble RG, Brewington J, Olukotun AY, Gore R. Comparative effects of nadolol-digoxin combination therapy and digoxin monotherapy for chronic atrial fibrillation. American Journal of Cardiology. 1987; 60(6):39D–45D [PubMed: 3307366]

Appendices

Appendix B. Literature search strategies

This literature search strategy was used for the following reviews;

  • What is the clinical and cost effectiveness of different non-ablative rate control therapies in people with atrial fibrillation?

The literature searches for this review are detailed below and complied with the methodology outlined in Developing NICE guidelines: the manual.103

For more information, please see the Methods Report published as part of the accompanying documents for this guideline.

B.1. Clinical search literature search strategy (PDF, 305K)

B.2. Health Economics literature search strategy (PDF, 244K)

Appendix D. Clinical evidence tables

Download PDF (232K)

Appendix E. Forest plots

E.1. Amiodarone vs. digoxin (PDF, 205K)

E.2. Beta-blockers vs. digoxin (PDF, 165K)

Appendix G. Health economic evidence selection

Figure 16. Flow chart of health economic study selection for the guideline (PDF, 256K)

Appendix H. Health economic evidence tables

None.

Appendix I. Excluded studies

I.1. Excluded clinical studies (PDF, 216K)

I.2. Excluded health economic studies (PDF, 122K)