Sotalol vs quinidine for maintenance of normal sinus rhythm in atrial fibrillation

Sotalol and quinidine appear to be more effective than control in maintaining sinus rhythm. Both agents appear to increase mortality with long-term therapy.

A systematic review including 11 RCTs with a total of subjects was abstracted in DARE. Efficacy rates for quinidine at 6 months ranged from 42% to 73%, and the point estimate of death was 3.0% (95% CI 1.7 to 4.7). Efficacy rates for sotalol at 6 months ranged from 42% to 71%, and the point estimate of death was 2.2% (95% CI 0.6 to 4.8%). Efficacy rates for control groups at 6 months ranged from 0% to 38%. The point estimate of death in the control group was 1.1% (95% CI 0.3 to 2.4).

Comment: The quality of evidence is downgraded by imprecise results (small effect size).

The following decision support rules contain links to this evidence summary:

• Avoiding sotalol

Ədəbiyyat

1. Southworth MR, Zarembski D, Viana M, Bauman J. Comparison of sotalol versus quinidine for maintenance of normal sinus rhythm in patients with chronic atrial fibrillation. Am J Cardiol 1999 Jun 15;83(12):1629-32.