Combination pharmacological cardioversion of permanent atrial fibrillation in post-prosthetic mitral valve replacement outpatients: a novel approach for the treatment of atrial fibrillation

This study explored the efficacy and safety of combination pharmacological cardioversion of permanent atrial fibrillation in outpatients following prosthetic mitral valve replacement. The study group comprised 99 outpatients who were randomly divided into two groups. In group 1 (n = 50), only ventricular heart rate was controlled. In group 2 (n = 49), combination pharmacological cardioversion therapy with low-dose oral amiodarone (2 mg/kg), captopril (0.25 mg/kg) and simvastatin (0.3 mg/kg) was administered daily. During 12 months of serial pharmacological treatment, the cardioversion rate was 6% for group 1 and 39% for group 2; the likelihood of cardioversion differed significantly between the two groups. In group 2, one patient developed severe pruritus that necessitated withdrawal from the study and six patients ceased captopril treatment after contracting a persistent cough. In summary, combination pharmacological cardioversion was found to be effective and safe in outpatients who had undergone prosthetic mitral valve replacement.