Key result
Quinidine was superior to verapamil in establishing and preserving sinus rhythm in patients with chronic atrial fibrillation (p<0.05).
Why the study?
Does quinidine improve the establishment and maintenance of sinus rhythm compared to verapamil in patients with chronic atrial fibrillation?
RCT (n=53)
cross-over
Does quinidine improve the establishment and maintenance of sinus rhythm compared to verapamil in patients with chronic atrial fibrillation?
Quinidine is superior to verapamil for establishing and maintaining sinus rhythm in chronic atrial fibrillation, but is associated with significant side effects and potential mortality risk.
Quinidine outperforms verapamil for pharmacological cardioversion in chronic AF; supports its preference in early rhythm-control strategies.
Fifty-three patients with chronic atrial fibrillation participated in a randomized cross-over trial in order to compare the ability of two drug regimens to establish and maintain sinus rhythm. The patients were given orally either sustained release quinidine 0.4 g twice day or verapamil 80 mg three times a day. Thirty-one patients tried both regimens. Quinidine was found to have a greater ability to induce conversion to sinus rhythm by drug alone (p less than 0.05) and also a greater ability to maintain sinus rhythm after conversion (after 3 months p less than 0.05). There was, however, also a significantly larger proportion of patients on quinidine who were withdrawn from the study due to side effects and two patients on quinidine died outside hospital. The study indicate that quinidine is somewhat superior to verapamil both in the establishing and preserving of sinus rhythm in subjects who are able to tolerate the drug.
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Rasmussen et al. (1981) conducted an RCT in chronic atrial fibrillation (n=53). Quinidine vs. Verapamil 80 mg three times a day was evaluated on Conversion to and maintenance of sinus rhythm (p=<0.05). Quinidine was superior to verapamil in establishing and preserving sinus rhythm in patients with chronic atrial fibrillation (p<0.05).
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