Study designs of evaluations included in the review
Randomised controlled trials (RCTs), and cohort studies where RCTs were not available.
Specific interventions included in the review
External and internal cardioversion (direct-current). For oral pharmacological conversion, the effectiveness of digoxin, amiodarone, sotalol, quinidine, flecainide, propafenone are examined. Intravenous agents discussed, include digoxin, amiodarone, sotalol, flecainide, propafenone, esmolol, disopyramide and pirmenol. Maintenance of sinus rhythm is examined with reference to pharmacologic therapy using quinidine, disopyramide, sotalol, flecainide, amiodarone and beta-blockers. Cardiac pacing (both single- and dual-chamber ventricular pacing) is also examined in this context, along with surgical corridor and maze procedures.
In addition, antithrombotic therapy is examined, and the effectiveness of warfarin, aspirin and anticoagulants is assessed.
Participants included in the review
Patients with atrial fibrillation. A small number of studies included patients with fibrillation after cardiac surgery.
Outcomes assessed in the review
The main outcome was restoration of sinus rhythm. Reduction in incidence of ischaemic stroke and emboli is also discussed in the context of antithrombotic therapies.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.