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 .
[A comparison between flecainide and sotalol in the prevention of recurrences of paroxysmal atrial fibrillation].
OBJECTIVES Aim of the present study was to assess the efficacy and safety of flecainide ( F ) and sotalol ( S ) for the prevention of recurrences of paroxysmal atrial fibrillation ( PAF ) . METHODS Sixty-six patients with PAF ( > or = 3 episodes of atrial fibrillation in the last year ) in sinus rhythm , were r and omized to pharmacological oral treatment with F  ( 20 patients -Group A ) , with S ( 20 patients -Group B ) and placebo ( P ) ( 26 patients -Group C ) . During the follow-up ( one year duration ) were evaluated on I , III , VI and XII months the number and tolerance of the atrial fibrillation recurrences , cardiac and /or noncardiac side effects .  The patients with more than two recurrences in the same follow-up interval withdrew from the study . In each patient 14 clinical and laboratory variables were evaluated . RESULTS After 12 months were arrhythmia-free respectively 70 % of Group A patients , 60 % of Group B patients , 27 % of Group C patients . Univariate analysis showed that treatment with F was related to decrease of atrial fibrillation recurrences ( one recurrence 67 % , two recurrences 81 % , three recurrences 81 % ) , treatment with S was related to decrease of recurrences ( two recurrences 59 % ) ; the variable most significantly related to the risk of arrhythmia recurrence is the higher value of basal cardiac rate ( one recurrence t = 2.15 , two t = 2.22 , three t = 2.96 , four t = 2.06 ) . There was not statistically significant difference in maintenance of sinus rhythm at the end of the follow-up between the groups of patients on F and S ( p = 0.163 ) ; treatment efficacy was significantly higher than P ( p = 0.002 ) . Multivariate analysis showed that treatment with F and S decreases the risk of arrhythmia recurrence respectively of 85 % and 76 % versus placebo at the end of the follow-up . The incidence of cardiac and /or noncardiac side effects was not clinical ly significant . CONCLUSION F and S are both effective and safe for prevention of PAF , with 70 % and 60 % respectively of patients arrhythmia-free after 12 months of treatment . Side effects were common , but clinical ly significant adverse events were uncommon . A higher value of basal cardiac rate was predictive of atrial fibrillation recurrences in the patients during treatment
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 .