Circulation, Vol 82, 1106-1116, Copyright © 1990 by American Heart Association
SE Coplen, EM Antman, JA Berlin, P Hewitt and TC Chalmers
Because individual studies evaluating the role of quinidine in the
maintenance of sinus rhythm after cardioversion from chronic atrial
fibrillation have involved relatively few patients, a meta-analysis of
randomized control trials was performed. Six trials published between 1970
and 1984 were selected by two blinded reviewers based on study design and
statistical analysis. Data from these six trials involving 808 patients
were pooled after testing for homogeneity of treatment effects across
trials. Life table estimates of the percent of patients still in sinus
rhythm at 3, 6, and 12 months after cardioversion were constructed for
quinidine and control groups. The proportion of patients remaining in sinus
rhythm in the quinidine group was 69%, 58%, and 50% at 3, 6, and 12 months
postcardioversion respectively. The proportion of patients remaining in
sinus rhythm in the control group was 45%, 33%, and 25% at the same time
intervals. The pooled rate difference, or difference in proportion of
patients in sinus rhythm between quinidine and control groups, was 24%,
23%, and 24% at 3, 6, and 12 months of follow-up (p less than 0.001 at all
time intervals). The unadjusted total mortality rate in the
quinidine-treated patients was 2.9% and in the control group was 0.8%. The
odds of dying in the quinidine-treated group were approximately three times
that of the control group ("typical" odds ratio = 2.98, p less than 0.05).
Thus, quinidine treatment is more effective than no antiarrhythmic therapy
in suppressing recurrences of atrial fibrillation but appears to be
associated with increased total mortality.
ARTICLES
Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials [published erratum appears in Circulation 1991 Feb;83(2):714]
Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115.
This article has been cited by other articles:
 |
|
 |
|
  D. Roy, M. Talajic, S. Nattel, D. G. Wyse, P. Dorian, K. L. Lee, M. G. Bourassa, J. M. O. Arnold, A. E. Buxton, A. J. Camm, et al. Rhythm Control versus Rate Control for Atrial Fibrillation and Heart Failure N. Engl. J. Med., June 19, 2008; 358(25): 2667 - 2677. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. Koistinen, M. Valtonen, J. Savola, and J. Airaksinen Thoracoscopic microwave ablation of atrial fibrillation Interactive CardioVascular and Thoracic Surgery, December 1, 2007; 6(6): 695 - 698. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. N. Singh, S. J. Connolly, H. J.G.M. Crijns, D. Roy, P. R. Kowey, A. Capucci, D. Radzik, E. M. Aliot, S. H. Hohnloser, and the EURIDIS and ADONIS Investigators Dronedarone for Maintenance of Sinus Rhythm in Atrial Fibrillation or Flutter N. Engl. J. Med., September 6, 2007; 357(10): 987 - 999. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. H. Hohnloser and E. N. Prystowsky CRT-D use in heart failure: too little or too much? Eur. Heart J. Suppl., September 1, 2007; 9(suppl_G): G9 - G16. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. M. Roden, P. Kannankeril, and D. Darbar On the relationship among QT interval, atrial fibrillation, and torsade de pointes Europace, September 1, 2007; 9(suppl_4): iv1 - iv3. [Full Text] [PDF]
|
|
|
|
|
|
E. Shantsila, T. Watson, and G. Y. Lip Drug-induced QT-interval prolongation and proarrhythmic risk in the treatment of atrial arrhythmias Europace, September 1, 2007; 9(suppl_4): iv37 - iv44. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. K Nergardh, M. Rosenqvist, R. Nordlander, and M. Frick Maintenance of sinus rhythm with metoprolol CR initiated before cardioversion and repeated cardioversion of atrial fibrillation: a randomized double-blind placebo-controlled study Eur. Heart J., June 1, 2007; 28(11): 1351 - 1357. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D. Gupta, M. J Earley, G. A Haywood, L. Richmond, M. Fitzgerald, P. Kojodjojo, S. C Sporton, N. S Peters, P. Broadhurst, R. J Schilling, et al. Can atrial fibrillation with a coarse electrocardiographic appearance be treated with catheter ablation of the tricuspid valve-inferior vena cava isthmus? Results of a multicentre randomised controlled trial Heart, June 1, 2007; 93(6): 688 - 693. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Writing Committee Members, V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, et al. ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: full text: A report of the American College of Cardiology/American Heart Association Task Force on practice guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society Europace, September 1, 2006; 8(9): 651 - 745. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society J. Am. Coll. Cardiol., August 15, 2006; 48(4): e149 - e246. [Full Text] [PDF]
|
|
|
|
 |
|
 V. Fuster, L. E. Ryden, D. S. Cannom, H. J. Crijns, A. B. Curtis, K. A. Ellenbogen, J. L. Halperin, J.-Y. Le Heuzey, G. N. Kay, J. E. Lowe, et al. ACC/AHA/ESC 2006 Guidelines for the Management of Patients With Atrial Fibrillation: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): Developed in Collaboration With the European Heart Rhythm Association and the Heart Rhythm Society Circulation, August 15, 2006; 114(7): e257 - e354. [Full Text] [PDF]
|
|
|
|
 |
|
 C. Lafuente-Lafuente, S. Mouly, M. A. Longas-Tejero, I. Mahe, and J.-F. Bergmann Antiarrhythmic drugs for maintaining sinus rhythm after cardioversion of atrial fibrillation: a systematic review of randomized controlled trials. Arch Intern Med, April 10, 2006; 166(7): 719 - 728. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Z. Goldberger and R. Lampert Implantable Cardioverter-Defibrillators: Expanding Indications and Technologies JAMA, February 15, 2006; 295(7): 809 - 818. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M C S Hall and D M Todd Modern management of arrhythmias Postgrad. Med. J., February 1, 2006; 82(964): 117 - 125. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. P. Roose and M. Miyazaki Pharmacologic Treatment of Depression in Patients With Heart Disease Psychosom Med, May 1, 2005; 67(Supplement_1): S54 - S57. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. Shelton Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial Eur. Heart J., December 1, 2004; 25(23): 2174 - 2174. [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Kang, B. J. Daly, and J.-S. Kim Uncertainty and Its Antecedents in Patients With A trial Fibrillation West J Nurs Res, November 1, 2004; 26(7): 770 - 783. [Abstract] [PDF]
|
|
|
|
|
|
E. S. Kaufman, P. A. Zimmermann, T. Wang, G. W. Dennish III, P. D. Barrell, M. L. Chandler, H. L. Greene, and AFFIRM Investigators Risk of proarrhythmic events in the atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study: A multivariate analysis J. Am. Coll. Cardiol., September 15, 2004; 44(6): 1276 - 1282. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
T. Fetsch, P. Bauer, R. Engberding, H. P. Koch, J. Lukl, T. Meinertz, M. Oeff, L. Seipel, H. J. Trappe, N. Treese, et al. Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial Eur. Heart J., August 2, 2004; 25(16): 1385 - 1394. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. Patten, R. Maas, P. Bauer, B. Luderitz, F. Sonntag, M. Dluzniewski, R. Hatala, G. Opolski, H.-W. Muller, T. Meinertz, et al. Suppression of paroxysmal atrial tachyarrhythmias -- results of the SOPAT trial Eur. Heart J., August 2, 2004; 25(16): 1395 - 1404. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. Opolski, A. Torbicki, D. A. Kosior, M. Szulc, B. Wozakowska-Kaplon, P. Kolodziej, and P. Achremczyk Rate Control vs Rhythm Control in Patients With Nonvalvular Persistent Atrial Fibrillation: The Results of the Polish How to Treat Chronic Atrial Fibrillation (HOT CAFE) Study Chest, August 1, 2004; 126(2): 476 - 486. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. K Anthony and V. F Mauro Rate Versus Rhythm Control in Atrial Fibrillation Ann. Pharmacother., May 1, 2004; 38(5): 839 - 844. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. Stellbrink, U. Nixdorff, T. Hofmann, W. Lehmacher, W. G. Daniel, P. Hanrath, C. Geller, A. Mugge, W. Sehnert, C. Schmidt-Lucke, et al. Safety and Efficacy of Enoxaparin Compared With Unfractionated Heparin and Oral Anticoagulants for Prevention of Thromboembolic Complications in Cardioversion of Nonvalvular Atrial Fibrillation: The Anticoagulation in Cardioversion using Enoxaparin (ACE) Trial Circulation, March 2, 2004; 109(8): 997 - 1003. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. E. Kochiadakis, N. E. Igoumenidis, M. I. Hamilos, P. G. Tzerakis, N. C. Klapsinos, E. A. Zacharis, and P. E. Vardas Long-term Maintenance of Normal Sinus Rhythm in Patients With Current Symptomatic Atrial Fibrillation: Amiodarone vs Propafenone, Both in Low Doses Chest, February 1, 2004; 125(2): 377 - 383. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
M. C. Fang, R. S. Stafford, J. N. Ruskin, and D. E. Singer National Trends in Antiarrhythmic and Antithrombotic Medication Use in Atrial Fibrillation Arch Intern Med, January 12, 2004; 164(1): 55 - 60. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. L. McNamara, L. J. Tamariz, J. B. Segal, and E. B. Bass Management of Atrial Fibrillation: Review of the Evidence for the Role of Pharmacologic Therapy, Electrical Cardioversion, and Echocardiography Ann Intern Med, December 16, 2003; 139(12): 1018 - 1033. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Schuetz, C.J. Schulze, K.K. Sarvanakis, H. Mair, H. Plazer, E. Kilger, B. Reichart, and S.M. Wildhirt Surgical treatment of permanent atrial fibrillation using microwave energy ablation: a prospective randomized clinical trial Eur. J. Cardiothorac. Surg., October 1, 2003; 24(4): 475 - 480. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. M. Prasad, H. S. Maniar, M. D. Diodato, R. B. Schuessler, and R. J. Damiano Jr Physiological consequences of bipolar radiofrequency energy on the atria and pulmonary veins: a chronic animal study Ann. Thorac. Surg., September 1, 2003; 76(3): 836 - 842. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Capucci and D. Aschieri Antiarrhythmic drug therapy: what is certain and what is to come Eur. Heart J. Suppl., September 1, 2003; 5(suppl_H): H8 - H18. [Abstract] [PDF]
|
|
|
|
|
|
S. M. Al-Khatib, N. M. A. LaPointe, J. M. Kramer, and R. M. Califf What Clinicians Should Know About the QT Interval JAMA, April 23, 2003; 289(16): 2120 - 2127. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
K. Shinagawa, A. Shiroshita-Takeshita, G. Schram, and S. Nattel Effects of Antiarrhythmic Drugs on Fibrillation in the Remodeled Atrium: Insights Into the Mechanism of the Superior Efficacy of Amiodarone Circulation, March 18, 2003; 107(10): 1440 - 1446. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. lost, L. Virag, A. Varro, and J. Gy. Papp Comparison of the Effect of Class IA Antiarrhythmic Drugs on Transmembrane Potassium Currents in Rabbit Ventricular Myocytes Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2003; 8(1): 31 - 41. [Abstract] [PDF]
|
|
|
|
|
|
G. Gronefeld and S. H. Hohnloser Rhythm or Rate Control in Atrial Fibrillation: Insights from the Randomized Controlled Trials Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2003; 8(1_suppl): S39 - S44. [Abstract] [PDF]
|
|
|
|
|
|
I. F. Lozano, A. Vincent, J. Roda, M. Méndez, J. M. M. Ferrer, F. Andrade, J. J. Manzano, R. Ceres, J. Errejon, and J. Toquero Paroxysmal atrial fibrillation prevention by pacing in patients with pacemaker indication Europace, January 1, 2003; 5(3): 267 - 273. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
I. C. Van Gelder, V. E. Hagens, H. A. Bosker, J. H. Kingma, O. Kamp, T. Kingma, S. A. Said, J. I. Darmanata, A. J.M. Timmermans, J. G.P. Tijssen, et al. A Comparison of Rate Control and Rhythm Control in Patients with Recurrent Persistent Atrial Fibrillation N. Engl. J. Med., December 5, 2002; 347(23): 1834 - 1840. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Khairy and S. Nattel New insights into the mechanisms and management of atrial fibrillation Can. Med. Assoc. J., October 29, 2002; 167(9): 1012 - 1020. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C-K Wong, H D White, R G Wilcox, D A Criger, R M Califf, E J Topol, and E M Ohman Management and outcome of patients with atrial fibrillation during acute myocardial infarction: the GUSTO-III experience Heart, October 1, 2002; 88(4): 357 - 362. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y Blaauw, I C Van Gelder, and H J G M Crijns Treatment of atrial fibrillation Heart, October 1, 2002; 88(4): 432 - 437. [Full Text] [PDF]
|
|
|
|
|
|
B. N. Singh Antiarrhythmic Drugs in Cardiac Arrest Resuscitation: Intravenous Amiodarone or Intravenous Lidocaine? Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2002; 7(2): 61 - 64. [PDF]
|
|
|
|
 |
|
 W. S. Aronow Management of the Older Person With Atrial Fibrillation J. Gerontol. A Biol. Sci. Med. Sci., June 1, 2002; 57(6): M352 - 363. [Abstract] [Full Text]
|
|
|
|
|
|
G Nichol, F McAlister, B Pham, A Laupacis, B Shea, M Green, A Tang, and G Wells Meta-analysis of randomised controlled trials of the effectiveness of antiarrhythmic agents at promoting sinus rhythm in patients with atrial fibrillation Heart, June 1, 2002; 87(6): 535 - 543. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G Breithardt, H Kuhn, D Hammel, H.-H Scheld, L Seipel, and D. Bocker Cardiac resynchronization therapy into the next decade: from the past to morbidity/mortality trials Eur. Heart J. Suppl., April 1, 2002; 4(suppl_D): D102 - D110. [Abstract] [PDF]
|
|
|
|
|
|
A. R. J. Mitchell, P. A. R. Spurrell, K. Kamalvand, M. Higson, R. Shanmuganathan, N. R. Patel, and N. Sulke What is the optimal electrode configuration for atrial defibrillators in man? Europace, January 1, 2002; 4(1): 41 - 44. [Full Text] [PDF]
|
|
|
|
|
|
J. Galperin, M. V. Elizari, P. A. Chiale, R. T. Molina, R. Ledesma, A. O. Scapin, and M. V. Blanco Efficacy of Amiodarone for the Termination of Chronic Atrial Fibrillation and Maintenance of Normal Sinus Rhythm: A Prospective, Multicenter, Randomized, Controlled, Double Blind Trial Journal of Cardiovascular Pharmacology and Therapeutics, December 1, 2001; 6(4): 341 - 350. [Abstract] [PDF]
|
|
|
|
 |
|
 G.Y.H. Lip and F.L. L. S. Hee Paroxysmal atrial fibrillation QJM, December 1, 2001; 94(12): 665 - 678. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Capucci, G.Q. Villani, N. Marrazzo, and M. Piepoli The complementary role of drug, ablation and device in the electrical therapy of atrial fibrillation Eur. Heart J. Suppl., November 1, 2001; 3(suppl_P): P47 - P52. [Abstract] [PDF]
|
|
|
|
|
|
R. C. Ziegelstein Depression in Patients Recovering From a Myocardial Infarction JAMA, October 3, 2001; 286(13): 1621 - 1627. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology Eur. Heart J., October 2, 2001; 22(20): 1852 - 1923. [PDF]
|
|
|
|
|
|
V. Fuster, L. E. Ryden, R. W. Asinger, D. S. Cannom, H. J. Crijns, R. L. Frye, J. L. Halperin, G. N. Kay, W. W. Klein, S. Levy, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to Develop Guidelines for the Management of Patients With Atrial Fibrillation) Developed in Collaboration With the North American Society of Pacing and Electrophysiology J. Am. Coll. Cardiol., October 1, 2001; 38(4): 1266 - 1266. [Full Text] [PDF]
|
|
|
|
|
|
B. Darpo Spectrum of drugs prolonging QT interval and the incidence of torsades de pointes Eur. Heart J. Suppl., September 1, 2001; 3(suppl_K): K70 - K80. [Abstract] [PDF]
|
|
|
|
|
|
A Plewan, G Lehmann, G Ndrepepa, J Schreieck, E.U Alt, A Schomig, and C Schmitt Maintenance of sinus rhythm after electrical cardioversion of persistent atrial fibrillation. Sotalol vs bisoprolol Eur. Heart J., August 2, 2001; 22(16): 1504 - 1510. [Abstract] [PDF]
|
|
|
|
|
|
J. A. Reiffel and G. Appel Importance of QT Interval Determination and Renal Function Assessment During Antiarrhythmic Drug Therapy Journal of Cardiovascular Pharmacology and Therapeutics, June 1, 2001; 6(2): 111 - 119. [Abstract] [PDF]
|
|
|
|
|
|
E. Raanani, A. Albage, T. E. David, T. M. Yau, and S. Armstrong The efficacy of the Cox/maze procedure combined with mitral valve surgery: a matched control study Eur. J. Cardiothorac. Surg., April 1, 2001; 19(4): 438 - 442. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. N. Singh and J. S. M. Sarma Mechanisms of Action of Antiarrhythmic Drugs Relative to the Origin and Perpetuation of Cardiac Arrhythmias Journal of Cardiovascular Pharmacology and Therapeutics, March 1, 2001; 6(1): 69 - 87. [PDF]
|
|
|
|
|
|
F. Lombardi, A. Colombo, B. Basilico, R. Ravaglia, M. Garbin, D. Vergani, P. M. Battezzati, and C. Fiorentini Heart rate variability and early recurrence of atrial fibrillation after electrical cardioversion J. Am. Coll. Cardiol., January 1, 2001; 37(1): 157 - 162. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
X. Zheng, M. E. Benser, G. P. Walcott, S. D. Girouard, D. L. Rollins, W. M. Smith, and R. E. Ideker Reduction of Atrial Defibrillation Threshold With an Interatrial Septal Electrode Circulation, November 21, 2000; 102(21): 2659 - 2664. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Sing |