No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .
Efficacy and safety of sotalol versus quinidine for the maintenance of sinus rhythm after conversion of atrial fibrillation. SOCESP Investigators. The Cardiology Society of São Paulo.
To compare the efficacy and safety of sotalol and quinidine  after conversion of atrial fibrillation ( AF ) of < 6 months , a prospect i ve multicenter trial enrolled 121 patients who were r and omized to receive dl-sotalol ( 160 to 320 mg/day , 58 patients ) or quinidine sulfate ( 600 to 800 mg/day , 63 patients ) . Patients with left ventricular ejection fraction of < 0.40 or left atrial diameter > 5.2 cm were excluded . After 6 months of follow-up , using the Kaplan-Meier method , the probabilities of success were comparable between sotalol ( 74 % ) and quinidine ( 68 % ) , but recurrences occurred later with sotalol than with quinidine ( 69 vs 10 days , p < 0.05 ) . Four patients developed proarrhythmic events , 3 ( 5 % ) with sotalol and 1 ( 2 % ) with quinidine , which were all associated with diuretic therapy . In patients converted from recent-onset AF ( < or = 72 hours ) , sotalol was more effective than quinidine ( 93 % vs 64 % , p = 0.01 ) , whereas in chronic AF ( > 72 hours ) , quinidine was more effective than sotalol ( 68 % vs 33 % , p < 0.05 ) . During recurrences , the ventricular rate was significantly reduced in patients taking sotalol ( 98 to 82 beats/min , p < 0.05 ) . Independent predictors of therapeutic success were recent-onset AF in the sotalol group ( p < 0.001 ) and absence of hypertension in the quinidine group ( p < 0.05 ) . In conclusion , sotalol and quinidine have comparable efficacy and safety for the maintenance of sinus rhythm in the overall group . In recent-onset AF , sotalol was more effective , whereas in chronic AF , quinidine had a better result . Recurrences occurred later with sotalol when compared with quinidine . Because of proarrhythmia , these drugs should be used judiciously in patients on diuretic therapy
No other antiarrhythmic showed a significant effect on mortality compared with controls .
Class IA , IC , and III drugs are effective in maintaining sinus rhythm but increase adverse effects , and class IA drugs may increase mortality
BACKGROUND A variety of antiarrhythmic drugs have been used to prevent recurrence of atrial fibrillation after conversion to sinus rhythm .
We performed a systematic review to determine the effect of long-term treatment with those drugs on death , embolisms , adverse effects , and atrial fibrillation recurrence .