Assessment of the comparative effectiveness of individual AADs on CV hospitalization and mortality end points is not possible with the current evidence
AIM To assess , through a systematic review , evidence for the effects of antiarrhythmic drugs ( AADs ) on  cardiovascular ( CV ) hospitalization and mortality .
The Drug And Pace Health cliNical Evaluation (DAPHNE) study: a randomized trial comparing sotalol versus beta-blockers to treat symptomatic atrial fibrillation in patients with brady-tachycardia syndrome implanted with an antitachycardia pacemaker.
BACKGROUND Atrial tachyarrhythmias ( ATAs ) are mainly treated by pharmacologic therapy for rate control or rhythm control . The aim of our study was to compare sotalol ( S ) versus beta-blocking agents ( BB ) in terms of prevention of ATA , cardioversions ( CVs ) , and cardiovascular hospitalizations ( H ) in patients paced for bradycardia-tachycardia form of sinus node disease ( BT-SND ) . METHODS One hundred thirty-five patients ( 67 males , aged 73 + /- 7 years ) were enrolled in a prospect i ve , parallel , r and omized , single-blind , multicenter study . All patients received a dual chamber rate adaptive pacemaker ; after 1 month , 66 patients were r and omly assigned to BB ( 62 + /- 26 and 104 + /- 47 mg/d for atenolol and metoprolol , respectively ) and 69 patients to S ( 167 + /- 66 mg/d ) . RESULTS After an observation period of 12 months , the percentage of patients free from ATA recurrences was 29 % in both BB and S group . Cardioversion and H were significantly ( P < .01 ) fewer in the 12 months after implantation than in the 12 months before both in patients treated with S ( CV 69.4 % vs 22.2 % , H 91.7 % vs 33.3 % ) and in patients treated with BB ( CV 58.5 % vs 17.1 % , H 82.9 % vs 26.8 % ) . Kaplan-Meier survival analysis showed a nonsignificant trend toward a lower incidence of the composite end point ( CV + H ) among BB patients . CONCLUSIONS In the complex context of " hybrid therapy " in patients with BT-SND implanted with a modern dual chamber rate adaptive pacemaker device delivering atrial antitachycardia pacing , no differences were found between the use of beta-blocker and the use of S , at the relatively low dose achieved after clinical titration , in terms of prevention of cardiovascular H or need for atrial CV
Assessment of the comparative effectiveness of individual AADs on CV hospitalization and mortality end points is not possible with the current evidence
AIM To assess , through a systematic review , evidence for the effects of antiarrhythmic drugs ( AADs ) on  cardiovascular ( CV ) hospitalization and mortality .