The Clinical Efficacy And Adverse Reaction Of Wenxin Granule And Amiodarone For Patient With Atrial Fibrillation: A Meta-Analysis

Objective: To systematically evaluate the efficacy and adverse reaction of Wenxin Granule on rhythm control in patients with atrial fibrillation (AF) either as a sole or in combination with amiodarone. Method: The databases of Cochrane Central Register of Controlled Trials, PubMed, Embase, the Chinese Biomedicine Database (CBM), China National Knowledge Infrastructure (CNKI), Wanfang system database and Chongqing VIP Information (CQVIP) database were systematically searched for all relevant studies. The cut-off date for the electronic search was January 2016. All randomized controlled trials (RCTs) with enrolled patients of all ages with atrial fibrillation (AF) were included in the present study. The primary outcomes were the incidence of adverse events and the rate of rhythm control which was defined as the cardioversion and sinus rhythm maintenance in AF patients. For dichotomous outcomes, the rate of rhythm control and the incidence of adverse drug reaction were calculated as a relative risk (RR) with 95% confidence intervals (95% CI) in a fixed effects model. Result: A total of 15 trails (1,539 participants) were included in the meta-analysis. Compared with amiodarone, the group of Wenxin granule did not show statistical significance in rhythm control (RR: 0.91; 95% CI: [0.75, 1.09], P=0.30) but lower adverse events (RR: 0.54, 95% CI: [0.32, 0.90], P=0.02) while the group of Wenxin granule combined with amiodarone increased rate of sinus rhythm maintenance (RR: 1.34; 95% CI: [1.22, 1.47], P<0.01) and did not increase the incidence of adverse events (RR: 0.51, 95% CI: [0.32, 0.80], P<0.01). Trim and fill method was performed to correct the pooled effect for the funnel pot asymmetry (adjusted value of RR=1.172, 95% CI: [1.088, 1.264]). Conclusion: Wenxin granule as a sole or adjuvant agent on maintaining sinus rhythm in patients with AF was promising. However there were some methodological defects in the included studies. Further rigorously designed trials are needed to substantiate its clinical usage.