Abstract:
AIMS:Treatment of atrial fibrillation remains a major clinical challenge owing to the limited efficacy and safety of anti-arrhythmic drugs, particularly in patients with structural heart disease. METHODS AND RESULTS:To evaluate the efficacy of azimilide, a new class III anti-arrhythmic drug, we studied 658 patients with symptomatic persistent atrial fibrillation, adequate anticoagulant therapy, and planned electrical cardioversion. Patients were randomized to placebo, azimilide (125 mg o.d.), or sotalol (160 mg b.i.d.). Primary efficacy analysis was based on event recurrence, which was defined as atrial fibrillation lasting>24 h, or requiring DC cardioversion. Median time to recurrence was 14 days for azimilide, 12 days for placebo, and 28 days for sotalol (P=0.0320 when comparing azimilide with placebo; P=0.0002 when comparing azimilide with sotalol). The placebo-to-azimilide hazard ratio was 1.291 (95% CI: 1.022-1.629) and the sotalol-to-azimilide hazard ratio was 0.652 (95% CI: 0.523-0.814). Adverse events causing patient withdrawal were more frequent (P<0.01) in patients on azimilide (12.3%) and on sotalol (13.9%) than on placebo (5.4%). Eight patients in the sotalol (3.5%) and 16 in the azimilide (7.6%) group interrupted the study because of QTc prolongation. Torsade de pointes was reported in five patients of the azimilide group. The percentage of patients who completed the 26 week study period without events were 19% for azimilide, 15% for placebo, and 33% for sotalol (P<0.01). Unsuccessful day 4 cardioversion, arrhythmia recurrence, and adverse events were the main causes of withdrawal from the study. CONCLUSION:This study demonstrates that the anti-arrhythmic efficacy of azimilide is slightly superior to placebo but significantly inferior to sotalol in patients with persistent AF. The modest anti-arrhythmic efficacy and high rate of torsade de pointes and marked QTc prolongation limit azimilide utilization for the treatment of AF.
journal_name
Eur Heart Jjournal_title
European heart journalauthors
Lombardi F,Borggrefe M,Ruzyllo W,Lüderitz B,A-COMET-II Investigators.doi
10.1093/eurheartj/ehl209subject
Has Abstractpub_date
2006-09-01 00:00:00pages
2224-31issue
18eissn
0195-668Xissn
1522-9645pii
ehl209journal_volume
27pub_type
杂志文章,随机对照试验abstract::From 1978 to 1980, 260 healthy subjects, 40-79 years of age, underwent 24 h ambulatory electrocardiography in order to determine the prevalence and complexity of ventricular premature beats (VPBs) in adults without apparent heart disease. The number of types of VPBs seem in 5% or less were considered 'abnormal' and th...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a059946
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abstract::Chronic kidney disease (CKD) is associated with high cardiovascular risk. CKD patients exhibit a specific lipoprotein pattern termed 'uraemic dyslipidaemia', which is characterized by rather normal low-density lipoprotein cholesterol, low high-density lipoprotein cholesterol, and high triglyceride plasma levels. All t...
journal_title:European heart journal
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doi:10.1093/eurheartj/ehaa1050
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journal_title:European heart journal
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doi:10.1093/oxfordjournals.eurheartj.a059721
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abstract::The pharmacokinetics of glyceryl trinitrate are still not completely understood. The substance disappears rapidly from plasma largely by extrahepatic mechanisms. It is converted in glyceryl dinitrates and glyceryl mononitrates. After transdermal application of a controlled delivery system, plasma concentrations of gly...
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pub_type: 杂志文章,评审
doi:10.1093/eurheartj/9.suppl_a.33
更新日期:1988-01-01 00:00:00
abstract:BACKGROUND:Atrial abnormalities in patients with progressive systemic sclerosis have not been evaluated in terms of intra-atrial conduction. We hypothesized that a delay in atrial conduction in these patients might produce diastolic abnormalities as well as atrial arrhythmias. OBJECTIVE:To evaluate the atrial function...
journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/oxfordjournals.eurheartj.a015211
更新日期:1997-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.3034
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/ehr084
更新日期:2011-06-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
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更新日期:1999-10-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1093/eurheartj/14.7.941
更新日期:1993-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,评审
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更新日期:2003-05-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.1999.1714
更新日期:1999-12-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,meta分析,评审
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更新日期:2017-06-07 00:00:00
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更新日期:2019-07-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,随机对照试验
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更新日期:2015-10-07 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
doi:10.1053/euhj.2001.2730
更新日期:2002-02-01 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1993-11-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1093/eurheartj/ehy451
更新日期:2018-09-01 00:00:00
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journal_title:European heart journal
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pub_type: 杂志文章,随机对照试验
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pub_type: 杂志文章,多中心研究
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journal_title:European heart journal
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pub_type: 杂志文章
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pub_type: 杂志文章
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更新日期:2011-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:2018-05-21 00:00:00
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journal_title:European heart journal
pub_type: 临床试验,杂志文章,随机对照试验
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更新日期:1991-12-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:1984-09-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:1998-04-01 00:00:00
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journal_title:European heart journal
pub_type: 杂志文章
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更新日期:2001-05-01 00:00:00
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pub_type: 杂志文章
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更新日期:2013-04-01 00:00:00