Effectiveness And Safety Of Ibutilide Combined Propafenone In Cardioversion Of Atrial Fibrillation And Atrial Flutter: A Meta-analysis

Objective To evaluate the therapeutic effectiveness and safety of ibutilide combined with propafenone versus ibutilide or propafenone which is only used in the treatment of atrial fibrillation and atrial flutte.Methods An electronic search related articles ibibutilide combined with propafenone on cardioversion of atrial fibrillation or atrial flutter, in both English and randomized controlled trials(RCT),in databases including Pub Med, EMbase, libraries CNKI, Wanfang data, VIP databases and the Cochrane Library, during from January 1994 to April 2015. Two researchers responsible for inclusion and exclusion criteria for article filtering, data extraction and methodological quality assessment.Rev Man 5.3 software is used to Meta analyses. Five RCTs involving 664 patients were finally included. The results of Meta—analysis showed:(1) ibutilide propafenone combined group efficiency(66.99%) than with ibutilide Group(46.08%), there was a significant difference between the two groups [OR=2.34,95%CI(1.33,4.10), P <0.004]. Ibutilide propafenone combined group efficiency(66.67%) than using propafenone Group(48.51%), the difference between the two groups was statistically significant OR=2.12,95%CI(1.42,3.17), P <0.0002]; II the 3 studies combined analysis showed that ibutilide and propafenone group rate(64.84%) than ibutilide and propafenone alone Group(43.16%), there was a significant difference between the two groups [OR=2.37,95%CI( 1.32,4.27), P =0.004];(3) 3 studies showed that ibutilide joint group of propafenone atrial fibrillation cardioversion of ibutilide takes significantly longer than single groups, there was a significant difference in [MD=20.75,95%CI(11.04,30.46), P <0.0001]; II 3 research results showed that ibutilide propafenone combined total incidence of adverse reactions(12.66%) than ibutilide and propafenone alone Group(2.77%) But no statistically significant difference between the two groups [RD=0.04,95%CI(0.09,0.18), P =0.53].Conclusion Ibutilide combined with propafenone in treatment of atrial fibrillation or atrial flutter, the total recovery rate and the success rate is higher than the individual separate cardioversion for atrial fibrillation with ibutilide and propafenone, cardioversion of atrial flutter and atrial fibrillation significantly longer than the individual therapy group; The evidence is insufficient that ibutilide propafenone combined incidence of adverse reactions is higher than a separate group. Due to the limited quantity and quality of the included studies, more high quality randomized controlled trials are needed to confirm it.