Circulation, Vol 82, 1932-1939, Copyright © 1990 by American Heart Association
S Juul-Moller, N Edvardsson and N Rehnqvist-Ahlberg
This open, parallel-group study compares quinidine and sotalol treatment
for maintenance of sinus rhythm after direct current conversion of patients
with chronic atrial fibrillation. The patients from 15 centers in Sweden
were randomized to sotalol (98 patients) or quinidine (85 patients) after 2
hours of sinus rhythm after direct current conversion. According to primary
efficacy assessment, 52% of the patients in the sotalol group and 48% of
the patients in the quinidine group remained in sinus rhythm during the
following 6-month treatment period (NS). Furthermore, 34% of the patients
treated with sotalol and 22% of the patients treated with quinidine
relapsed into atrial fibrillation (NS). Heart rate after relapsing into
atrial fibrillation was higher in the patients treated with quinidine (109
beats/min) than in the patients treated with sotalol (78 beats/min, p less
than 0.001). Patients treated with sotalol were found to be less
symptomatic at the time of relapse compared with relapsing patients in the
quinidine group. In terms of safety, more patients were withdrawn from
quinidine than from sotalol treatment (26% vs. 11%, p less than 0.05), and
sotalol was generally better tolerated than quinidine. Twenty-eight percent
of the patients treated with sotalol and 50% of the patients treated with
quinidine reported side effects (p less than 0.01). The difference was
primarily a result of early (within the first month of treatment)
gastrointestinal and skin side effects in the group of patients treated
with quinidine.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Sotalol versus quinidine for the maintenance of sinus rhythm after direct current conversion of atrial fibrillation
Malmo General Hospital, Lund University, Stockholm, Sweden.
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