{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T10:29:15Z","timestamp":1760956155312,"version":"build-2065373602"},"reference-count":20,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2022,4,17]],"date-time":"2022-04-17T00:00:00Z","timestamp":1650153600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Pharmacological cardioversion (PCV) is commonly a primary option for termination of recent-onset atrial fibrillation (AF) in emergency departments (ED). This is a subanalysis of the CANT II study, evaluating the effectiveness and safety of antazoline in patients (n = 777) at three stages of chronic kidney disease (CKD): Group I &gt; 60 mL\/min (n = 531), Group II 45\u201359 mL\/min (n = 149), and Group III &lt; 45 mL\/min (n = 97). Patients in Group III were older and with a higher prevalence of co-morbidities; however, we did not find statistically significant differences in the overall effectiveness of PCV in comparison with the other groups. In patients receiving amiodarone, the PCV success rate was similar in all the studied groups, but along with a renal function decline, it decreased in patients receiving antazoline (79.1 vs. 35%; p &lt; 0.001), and it increased almost significantly in patients receiving propafenone (69.9 vs. 100%; p = 0.067). In patients in Group I, antazoline restored a sinus rhythm as effectively as propafenone and amiodarone; however, in patients in Group III, both antazoline and amiodarone became less effective in restoring a sinus rhythm than propafenone (p = 0.002 and p = 0.034, respectively). The rate of safety endpoint was the highest in patients in Group III (eGFR &lt; 45 mL\/min), and it was significantly higher than in patients in Groups I and II (p = 0.008 and p = 0.036, respectively). We did not observe antazoline-related adverse events in any of the studied groups of patients. This real-world registry analysis revealed a different influence of CKD on the effectiveness of individual drugs, and while propafenone and amiodarone maintained their AF termination efficacy, antazoline became significantly less effective in restoring sinus rhythm.<\/jats:p>","DOI":"10.3390\/ijerph19084880","type":"journal-article","created":{"date-parts":[[2022,4,18]],"date-time":"2022-04-18T04:21:28Z","timestamp":1650255688000},"page":"4880","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Pharmacological Cardioversion in Patients with Recent-Onset Atrial Fibrillation and Chronic Kidney Disease Subanalysis of the CANT II Study"],"prefix":"10.3390","volume":"19","author":[{"given":"Beata","family":"Ceynowa-Sielawko","sequence":"first","affiliation":[{"name":"Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1151-8385","authenticated-orcid":false,"given":"Maciej T.","family":"Wybraniec","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Upper Silesia Medical Centre, 40-635 Katowice, Poland"},{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksandra","family":"Topp-Zieli\u0144ska","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aleksander","family":"Maci\u0105g","sequence":"additional","affiliation":[{"name":"2nd Department of Heart Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8327-9550","authenticated-orcid":false,"given":"Dawid","family":"Mi\u015bkowiec","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pawe\u0142","family":"Balsam","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5092-7811","authenticated-orcid":false,"given":"Maciej","family":"W\u00f3jcik","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Chair and Department of Cardiology, Medical University of Lublin, 20-090 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wojciech","family":"Wr\u00f3bel","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Upper Silesia Medical Centre, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1673-7712","authenticated-orcid":false,"given":"Micha\u0142 M.","family":"Farkowski","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"2nd Department of Heart Arrhythmia, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Edyta","family":"\u0106wiek-R\u0119bowska","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3848-0922","authenticated-orcid":false,"given":"Krzysztof","family":"Oziera\u0144ski","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1853-5006","authenticated-orcid":false,"given":"Robert","family":"B\u0142aszczyk","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Chair and Department of Cardiology, Medical University of Lublin, 20-090 Lublin, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3481-4083","authenticated-orcid":false,"given":"Karolina","family":"Bula","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Upper Silesia Medical Centre, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tomasz","family":"Dembowski","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8519-3707","authenticated-orcid":false,"given":"Micha\u0142","family":"Peller","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9987-870X","authenticated-orcid":false,"given":"Bartosz","family":"Krzowski","sequence":"additional","affiliation":[{"name":"1st Chair and Department of Cardiology, Medical University of Warsaw, 02-097 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1220-9496","authenticated-orcid":false,"given":"Wojciech","family":"Wa\u0144ha","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Division of Cardiology and Structural Heart Diseases, Medical University of Silesia, Upper Silesia Medical Center, 40-635 Katowice, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6460-4802","authenticated-orcid":false,"given":"Marek","family":"Kozi\u0144ski","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Department of Cardiology and Internal Medicine, Medical University of Gdansk, 81-519 Gdynia, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jaros\u0142aw D.","family":"Kasprzak","sequence":"additional","affiliation":[{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"},{"name":"Department of Cardiology, Medical University of Lodz, 91-347 Lodz, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hanna","family":"Szwed","sequence":"additional","affiliation":[{"name":"Department of Coronary Artery Disease and Cardiac Rehabilitation, National Institute of Cardiology, 04-628 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6907-2799","authenticated-orcid":false,"given":"Katarzyna","family":"Mizia-Stec","sequence":"additional","affiliation":[{"name":"First Department of Cardiology, School of Medicine in Katowice, Medical University of Silesia, Upper Silesia Medical Centre, 40-635 Katowice, Poland"},{"name":"Club 30\u2032 of the Polish Cardiac Society, 00-193 Warsaw, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0367-4014","authenticated-orcid":false,"given":"Marek","family":"Szo\u0142kiewicz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Interventional Angiology, Kashubian Center for Heart and Vascular Diseases, Pomeranian Hospitals, 84-200 Wejherowo, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2022,4,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"2893","DOI":"10.1093\/eurheartj\/ehw210","article-title":"ESC Scientific Document Group: 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS","volume":"37","author":"Kirchhof","year":"2016","journal-title":"Eur. Heart J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1016\/j.ijcard.2018.01.101","article-title":"Prognostic role of cardiac calcifications in primary prevention: A powerful marker of adverse outcome highly dependent on underlying cardiac rhythm","volume":"258","author":"Mazzone","year":"2018","journal-title":"Int. J. Cardiol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"i4482","DOI":"10.1136\/bmj.i4482","article-title":"Atrial fibrillation and risks of cardiovascular disease, renal disease, and death: Systematic review and meta-analysis","volume":"354","author":"Odutayo","year":"2016","journal-title":"BMJ"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1056\/NEJMoa021328","article-title":"Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) Investigators. A comparison of rate control and rhythm control in patients with atrial fibrillation","volume":"347","author":"Wyse","year":"2002","journal-title":"N. Engl. J. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"1721","DOI":"10.1016\/j.amjcard.2007.01.059","article-title":"A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent-onset atrial fibrillation","volume":"99","author":"Kochiadakis","year":"2007","journal-title":"Am. J. Cardiol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"853","DOI":"10.1007\/s11739-016-1497-4","article-title":"Efficacy and safety in pharmacological cardioversion of recent-onset atrial fibrillation: A propensity score matching to compare amiodarone vs. class IC antiarrhythmic drugs","volume":"12","author":"Bonora","year":"2017","journal-title":"Intern. Emerg. Med."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1159","DOI":"10.1093\/europace\/euz175","article-title":"Vernakalant for cardioversion of recent-onset atrial fibrillation: A systematic review and meta-analysis","volume":"21","author":"McIntyre","year":"2019","journal-title":"Europace"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e010153","DOI":"10.1161\/JAHA.118.010153","article-title":"Pharmacological Cardioversion with Antazoline in Atrial Fibrillation: The Results of the CANT Study","volume":"7","author":"Wybraniec","year":"2018","journal-title":"J. Am. Heart Assoc."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1637","DOI":"10.1093\/europace\/euw384","article-title":"Efficacy and safety of antazoline in the rapid cardioversion of paroxysmal atrial fibrillation (the AnPAF Study)","volume":"19","author":"Farkowski","year":"2017","journal-title":"Europace"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"381","DOI":"10.20452\/pamw.3452","article-title":"Comparative effectiveness and safety of antazoline-based and propafenone-based strategies for pharmacological cardioversion of short-duration atrial fibrillation in the emergency department","volume":"126","author":"Farkowski","year":"2016","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Wybraniec, M.T., Maci\u0105g, A., Mi\u015bkowiec, D., Ceynowa-Sielawko, B., Balsam, P., W\u00f3jcik, M., Wr\u00f3bel, W., Farkowski, M., \u0106wiek-Rebowska, E., and Szo\u0142kiewicz, M. (2022). Efficacy and Safety of Antazoline for Cardioversion of Atrial Fibrillation: A Propensity Score Matching Analysis of Multicentre Registry (CANT II Study). Pol. Arch. Med. Wewn., 16234.","DOI":"10.20452\/pamw.16234"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1102","DOI":"10.1016\/j.ahj.2010.03.027","article-title":"Chronic Renal Insufficiency Cohort (CRIC) Study Group: Chronic kidney disease and prevalent atrial fibrillation: The Chronic Renal Insufficiency Cohort (CRIC)","volume":"159","author":"Soliman","year":"2010","journal-title":"Am. Heart J."},{"key":"ref_13","first-page":"448","article-title":"Chronic Kidney Disease and Atrial Fibrillation: A Contemporary Overview","volume":"5","author":"Kulkarni","year":"2012","journal-title":"J. Atr. Fibrillation"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"1254","DOI":"10.1253\/circj.CJ-20-0149","article-title":"Impact of renal dysfunction on left atrial structural remodeling and recurrence after catheter ablation for atrial fibrillation\u2014A propensity score matching analysis","volume":"84","author":"Takahashi","year":"2020","journal-title":"Circ. J."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"285","DOI":"10.1016\/j.jacc.2004.10.035","article-title":"Pre-existent left atrial scarring in patients undergoing pulmonary vein antrum isolation: An independent predictor of procedural failure","volume":"45","author":"Verma","year":"2005","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"3","DOI":"10.1016\/j.jjcc.2016.07.008","article-title":"Impaired renal function is associated with recurrence after cryoballoon catheter ablation for paroxysmal atrial fibrillation: A potential effect of non-pulmonary vein foci","volume":"69","author":"Yanagisawa","year":"2017","journal-title":"J. Cardiol."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"89","DOI":"10.5603\/CJ.a2013.0116","article-title":"Systematic review and meta-analysis of chronic kidney disease as predictor of atrial fibrillation recurrence following catheter ablation","volume":"21","author":"Li","year":"2014","journal-title":"Cardiol. J."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"e12441","DOI":"10.1111\/anec.12441","article-title":"Antazoline-insights into drug-induced electrocardiographic and hemodynamic effects: Results of the ELEPHANT II substudy","volume":"22","author":"Piotrowski","year":"2017","journal-title":"Ann. Noninvasive Electrocardiol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"e12244","DOI":"10.1111\/1755-5922.12244","article-title":"Effective suppression of atrial fibrillation by the antihistaminic agent antazoline: First experimental insights into a novel antiarrhythmic agent","volume":"35","author":"Frommeyer","year":"2017","journal-title":"Cardiovasc. Ther."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1097\/00045391-199704000-00004","article-title":"Propafenone in the conversion of atrial fibrillation in patients suffering from chronic renal failure","volume":"4","author":"Napoli","year":"1997","journal-title":"Am. J. Ther."}],"container-title":["International Journal of Environmental Research and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4880\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T22:55:41Z","timestamp":1760136941000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1660-4601\/19\/8\/4880"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,4,17]]},"references-count":20,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2022,4]]}},"alternative-id":["ijerph19084880"],"URL":"https:\/\/doi.org\/10.3390\/ijerph19084880","relation":{},"ISSN":["1660-4601"],"issn-type":[{"type":"electronic","value":"1660-4601"}],"subject":[],"published":{"date-parts":[[2022,4,17]]}}}