Estudio sobre los efectos adversos de los fármacos antiarrítmicos en pacientes con fibrilación auricular atendidos en un Centro de Atención Primaria
2011; Elsevier BV; Volume: 137; Issue: 6 Linguagem: Inglês
10.1016/j.medcli.2010.06.034
ISSN1578-8989
AutoresLuisa Benito, Jordi Hoyo, A. Montroig, Berta Fornés, Guillem Fluxà, David Martí Sánchez, Montserrat Pedrós, Antoni Sisó‐Almirall, Lluı́s Mont, Òscar Miró, Blanca Coll‐Vinent,
Tópico(s)Cardiac electrophysiology and arrhythmias
ResumoTo determine the adverse effects (AE) of antiarrhythmic drugs used to treat atrial fibrillation (AF) in routine clinical practice.A retrospective, observational, population-based study of all patients diagnosed of AF requiring long-term treatment with antiarrhythmic drugs. We performed also a descriptive analysis of the type of EA, and their management (diagnostic techniques, laboratory tests, drug treatment, number of visits to health services, emergency visits, hospitalizations and surgeries).We included 400 patients. Overall, 688 treatments were started, 34 of which (4.9%) were implied in 32 EA in 30 patients. The most frequent EA were hypothyroidism (28.1%), hyperthyroidism (25%) and bradycardia (9.38%). In absolute numbers, class III drugs (Vaughan-Williams classification) were associated with a higher number of AE (p=0.001). The number of AE/100 patients-year was: class I 0.42 (0.01-1.15%), class II 2.55 (0.68-5.13%), class III 4.70 (2.98-6.64%), class IV 1.18 (0.14-2.80%), digoxin 0.41 (0.08-1.19). Individually, the drugs with a higher rate were sotalol, bisoprolol and amiodarone (5.70, 5.37 and 4.59 respectively). 93.75% of EA required visits to health services, 59.38% laboratory tests and 56.25% diagnostic techniques. The most frequent visits were scheduled for primary care (75%), followed by scheduled visits to outpatient cardiology (21.9%). 71.9% of EA were resolved without any sequel and one patient died.Antiarrhythmic drugs for the management of AF are associated with the presence of AE, mainly class III drugs. In most cases they are not serious, but imply important health resources.
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