Efficacy and safety of ibutilide and amiodarone in treatment of atrial fibrillation and atrial flutter：A Meta-analysis

TONG Sui-yang; XIA Hao; WANG Xin; LI Lei; WANG Hui

doi:10.3969/j.1674-4055.2014.06.01

Abstract：Objective To review systematically the efficacy and safety of ibutilide and amiodarone in treatment of atrial fibrillation (AF) and atrial flutter (AFL).Methods The databases of CBM (1978-2014.4), CNKI (1994-2014.4), VIP Database (1999-2014.4), WanFang Database (1990~2014.4), PubMed (1990-2014.4), and Cochrane Library (4th issue of 2014) were retrieved for collecting randomized controlled trials (RCT) about comparison between ibutilide (test group) and amiodarone (control group) in treatment of AF and AFL. The data was screened and extracted by 2 researchers independently, and then the quality of the RCT was reviewed by applying homeostasis assessment recommended in Cochrane5.1 handbook and treated by using RevMan5.2 software.Results There were totally 489 RCT included, and finally there were 25 enclosed into Meta-analysis according to inclusion and exclusion criteria. The results of Meta-analysis showed: ①The total effective rate in alleviating AF/AFL was higher in test group than that in control group (OR=3.26, 95%CI: 2.60-4.08,P<0.00001). ②The total effective rate in alleviating AF was higher in test group than that in control group (OR=2.71, 95%CI: 2.04-3.58,P<0.00001). ③The total effective rate in alleviating AFL was higher in test group than that in control group (OR=7.05, 95%CI:4.13-12.04,P<0.00001). ④The average time in alleviating AF/AFL was shorter in test group than that in control group (WMD=-67.16 min, 95%CI: -87.27- -47.04,P<0.00001). ⑤The total incidence of adverse reactions had no significant difference between 2 groups (OR=1.02, 95%CI: 0.72-1.43,P=0.93).Conclusion The current studies show that ibutilide has higher efficacy and shorter average alleviating time compared with amiodarone in treatment of AF and AFL, and they have no difference in safety. As this analysis has limited quantity and quality in RCT, more large-sample RCT with higher quality are required for further identifying the results.