Quinidine maintenance therapy after first-time DC shock for atrial fibrillation resulted in a higher rate of sinus rhythm at 3 months compared to no quinidine (59% vs 34%).
Cohort (n=175)
Does quinidine improve the maintenance of sinus rhythm after electric conversion of atrial fibrillation?
Although quinidine significantly improved the maintenance of sinus rhythm at 3 months post-cardioversion, the authors recommend initial cardioversion without quinidine prophylaxis, reserving it for recurrences.
Absolute Event Rate: 59% vs 34%
p-value: p=highly significant
Onehundred andseventy-five patients withatrial fibrillation treated forthefirst timewithDC shock weredivided into twogroupsaccording toyearofbirth. GroupIreceived a long-acting quinidine bisulphate preparation, thedosage ofwhich was adjusted togive serumlevels of1-3mg./l. Side-effects wererarewiththis dosage. Group 2received noquinidine. Ofthe88patients ofgroup I,sinus rhythm was restored in75(85%). Whenleaving thehospital 64(73%) still hadsinus rhythm, andafter 3 months 52(59%). Thecorresponding figures forthe87patients ofGroup2 were 73(84%), 54(62%), and30(34%). Thedifference at3 months isstatistically highly significant. Because ofthese results itisconcluded thatelectric conversion ofatrial fibrillation should beperformed forthefirst timewithout quinidine prophylaxis. Ifthere isfailure orearly recurrence,however, a second electric conversion withsubsequent quinidine treatmentshould be considered.
Härtel et al. (1970) conducted a cohort in Atrial fibrillation (n=175). Quinidine bisulphate vs. No quinidine was evaluated on Maintenance of sinus rhythm at 3 months (p=highly significant). Quinidine maintenance therapy after first-time DC shock for atrial fibrillation resulted in a higher rate of sinus rhythm at 3 months compared to no quinidine (59% vs 34%).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: