DOI: 10.25881/BPNMSC.2020.87.97.017


Tyurin V.P., Pronin A.G., Prokopenko A.V.

Regional blood transfusion station, Ekaterinburg Pirogov National Medical and Surgical Center, Moscow


In 143 patients underwent drug-induced heart rate conversion. Niferidil was used as a drug for therapy in 50 patients, and amiodarone was used in 93 patients. A comparative analysis was performed to determine the effectiveness and safety of drug conversion of heart rhythm with these drugs in patients with atrial fibrillation and flutter. It was found that to restore sinus rhythm in patients with atrial fibrillation, niferidil is not inferior to amiodarone, and in patients with atrial flutter, it is superior to it, provided that atrial flutter has a tachysystolic variant. Amiodarone was statistically significantly safer in all groups for the development of such adverse complications as: the appearance of bradycardia with a heart rate of less than 50 beats per minute and the lengthening of the period of repolarization of the ventricles of the heart (the QTс interval on the ECG). Significantly more often in patients with atrial fibrillation and fluttering during conversion of heart rhythm with niferidil, ventricular extrasicitols were registered, but they spontaneously regressed in most patients in the first hours after administration of the drug.

Keywords: Pharmacological conversion of heart rhythm, amiodarone, niferidile, atrial fibrillation, atrial flutter.


1. Filatov AG, Tarashvili EG. Epidemiology and social significance of atrial fibrillation. Annaly aritmologii. 2012;9(2):5–13.

2. Chugh SS, Havmoeller R, Narayanan K, et al. Worldwide epidemiology of atrial fibrillation: a Global Burden of Disease 2010 Study. Circulation. 2014;129(8):837–847.

3. Kirchhof P, Benussi S, Kotecha D, et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Rev Esp Cardiol (Eng Ed). 2017;70(1):50. doi: 10.1016/j.rec.2016.11.033.

4. Fibrillyatsiya i trepetanie predserdii u vzroslykh. Klinicheskie rekomendatsii. Moscow: Minzdrav Rossii; 2016.

5. Karnik AA. Epidemiology of atrial fibrillation and heart failure: a growing and important problem. Cardiol Clinics. 2019;37(2):119–129. doi: 10.1016/j.ccl.2019.01.001.

6. Zulkifly H, Lip GYH, Lane DA. Epidemiology of atrial fibrillation. Int J Clin Practice. 2018;72(3):e13070. doi: 10.1111/ijcp.13070.

7. Revishvili ASh. Klinicheskie rekomendatsii po provedeniyu elektrofiziologicheskikh issledovanii, kateternoi ablyatsii i primeneniyu implantiruemykh antiaritmicheskikh ustroistv. Moscow: VNOA; 2017.

8. Lafuente-Lafuente C, Valembois L, Bergmann JF, et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2015;(3):CD005049. doi: 10.1002/14651858.CD005049.pub4.

9. Miller ON, Syrov AV, Doshchitsin VL, et al. Clinical guidelines and expert opinion on the use of antiarrhythmic drugs in actual practice. Consilium Medicum. 2019;21(5):43–50.

10. Maykov EB, Yuricheva YuA, Chazov EI, et al. Refralon (niferidil) is a new class III antiarrhythmic agent for pharmacological cardioversion for persistent atrial fibrillation and atrial flutter. Ther Arkh. 2015;87(1):38–48.

11. Chazov EI, Yuricheva YA, Maykov EB, et al. Efficacy and safety of new class III antiarrhythmic agent niferidil in reduction of with persistent atrial fibrillation and flutter. Kardiologicheskii vestnik. 2011;VI(1):5–15.

For citation

Tyurin V.P., Pronin A.G., Prokopenko A.V. Drug conversion of heart rhythm by amiodarone and niferidile in patients with atrial fibrillation and flutter. Bulletin of Pirogov National Medical & Surgical Center. 2020;3-2(15):92-95. (In Russ.)