Key result
Quinidine plus verapamil and sotalol reduced 1-year AF recurrence compared to placebo (65% and 67% vs 83%), but quinidine plus verapamil was superior to sotalol for persistent AF (38% vs 49%).
Why the study?
Do anti-arrhythmic drugs (sotalol or quinidine plus verapamil) prevent AF recurrence or death in patients with persistent AF after successful DC cardioversion?
Population
848 patients with persistent atrial fibrillation who were successfully direct current cardioverted
Comparison
Sotalol or quinidine plus verapamil vs Placebo
Design
RCT, Randomised to either sotalol, quinidine plus verapamil or placebo…
Follow-up
mean 266 days
Authors
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Supports AADs post-cardioversion to lower recurrence; reinforces RCT evidence for rhythm control in persistent AF.
Do anti-arrhythmic drugs (sotalol or quinidine plus verapamil) prevent AF recurrence or death in patients with persistent AF after successful DC cardioversion?
Anti-arrhythmic treatment with quinidine plus verapamil or sotalol after DC cardioversion of persistent AF significantly decreases recurrence rates compared to placebo, with quinidine plus verapamil showing superiority over sotalol for preventing persistent AF.
Thomas Fetsch (2004) studied this question. Quinidine plus verapamil and sotalol reduced 1-year AF recurrence compared to placebo (65% and 67% vs 83%), but quinidine plus verapamil was superior to sotalol for persistent AF (38% vs 49%).