CONVERSION RATE OF NEW ONSET ATRIAL FIBRILLATION IN HOSPITALIZED PATIENTS RECEIVING

AMIODARONE IN RSUD TARAKAN, NORTH KALIMANTAN

Herman H, Suwadiaya A, Putri EN, Mulyono MT, Yugo D

BACKGROUND

Atrial fibrillation (AF) is the most common, clinically relevant, arrhythmia with a prevalence about 2% in
general population. From MONICA (MONitoring of trend and determinant Cardiovascular disease) in Jakarta
the incident of atrial fibrillation is 0,2%, which men more often than women (3:2). The prognosis of atrial
fibrillation is depending on the onset of the disease. Converting new onset atrial fibrillation in less than 48
hour is increasing the prognosis of the disease.

OBJECTIVE

Our study aimed to show conversion rate of new onset AF to sinus rhythm in hospitalized patients receiving
amiodarone in less than 48 hours.

METHOD

We used data from medical record in RSUD Tarakan, North Kalimantan, from January to December 2015
using consecutive sampling. Patients diagnosed with new onset AF in medical wards were included in this
study, meanwhile the new onset AF that recorded in cardiologist clinic were excluded. First recorded atrial
fibrillation rhythm were defined as new onset AF. Conversion rate to sinus rhythm grouped into after loading
dose of amiodarone, more and less than 48 hours of maintenance dose of amiodarone.

RESULT

There were 9 patients diagnosed with new onset AF included in this study from the total of 49 patients
diagnosed with AF in year 2015, with median of age 67 years old (range 23-85 years old). Patients with new
onset AF consist of 6 male (66,7%) and 3 female (33,3%), mean age 59,22 + 15,96 years old, , 3 patients
(33,3%) received 1200mg oral loading dose of amiodarone and 6 patients (66,7%) received 150 mg loading
dose of amiodarone IV. There were 4 patients (44,4%) converted after receiving loading dose of amiodarone,
8 patients (88,9%) converted less than 48 hours and the total of 9 patients (100%) converted more than 48
hours after receiving maintenance dose of amiodarone.

DISCUSSION

The age range for AF in our study shifted to younger groups range of age 23-85 years old with median age 67
years old while the other study showed average age between 5-85 years old. Compared to MONICA study
patients with new onset AF has similar result in incidence of new onset AF which men more often than
women (2:1). Our study shows similar conversion rate after loading dose (44,4%) compared to previous
study (Khan et. al., 2003) reported efficacy conversion after bolus only regimens 34-69%, and higher
conversion rate (88,9%-100%) after receiving maintenance dose compared to 55-95% bolus followed by
infusion regimens on previous study. Meanwhile our study shows higher conversion rate (44,4%) after
loading dose compared to other study (Camm et. al., 2011) reported conversion rate was achieved in 5,2-
32,8% patients.

CONCLUSION

Amiodarone shows higher conversion rate of new onset AF to sinus rhythm in less than 48 hours in our
population compared than previous similar study.

Keywords: Atrial Fibrillation, New Onset AF, amiodarone, convert rate, pharmacological cardioversion