Arrhythmias and Conduction DisturbancesComparison of sotalol versus quinidine for maintenance of normal sinus rhythm in patients with chronic atrial fibrillation
Section snippets
Methods
A literature search was performed of the MEDLINE databases of the National Library of Medicine. From 1985 to the present, the search term “sotalol” was crossed with “atrial fibrillation” and “atrial flutter”; results of this search were crossed with the broad search strategy “clinical trial.” A similar search was performed from 1990 to the present using the search term “quinidine” These data were combined with data extracted from the previous meta-analysis1 to form a comprehensive collection of
Results
The literature search identified 19 quinidine-related studies and 14 sotalol-related studies. Of these, 10 sotalol and 10 quinidine studies were excluded for various reasons: study subjects were not being treated for chronic AF or were being treated for paroxysmal AF (6 studies), data were not available for predetermined time points (9 studies), subjects were being treated for postoperative AF (6 studies), inappropriate drug form was used (IV quinidine, nonracemic sotalol) (3 studies), and the
Discussion
Since the early 1900s, quinidine has been considered the drug of first choice for maintaining SR. However, the visible and influential publication of the Coplen et al meta-analysis after the CAST trial17 further questioned the long-term safety of antiarrhythmic drugs. In the analysis of Coplen et al, randomized, controlled trials investigating the efficacy and safety of quinidine in AF were combined. Quinidine was more effective than control (53% vs 32% remaining in normal SR at 6 months), but
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Quinidine—A legacy within the modern era of antiarrhythmic therapy
2019, Pharmacological ResearchCitation Excerpt :This clinical picture was already described in 1964 from Selzer and Wray and defined as “quinidine syncope” occurring within 1–3 h after the last quinidine dose [9]. Data from meta-analysis and a Cochrane’s Database Analysis found a significant trend of increased mortality with long-term therapy with estimated mortality rates of 3% for quinidine versus 2.2% for sotalol and 1.1% for control [10,11]. In 1991, Morganroth published a meta-analysis comparing quinidine with flecainide, mexiletine, tocainide and propafenone demonstrating a significantly higher risk of dying taking quinidine compared with the other drugs.
Influence of Gender on the Tolerability, Safety, and Efficacy of Quinidine Used for Treatment of Supraventricular and Ventricular Arrhythmias
2015, American Journal of CardiologyQuinidine Revisited
2009, American Journal of MedicineCitation Excerpt :Some of the arrhythmia-related deaths may have been due to digoxin toxicity. Southworth and colleagues7 demonstrated a nonsignificant trend for mortality with long-term treatment. Of the 7 studies examined for quinidine, 4 were the same studies examined by Coplen and colleagues,6 which predated knowledge of the quinidine–digoxin interaction.
Selection of drugs in pursuit of rate control strategy
2005, Progress in Cardiovascular DiseasesSotalol versus propafenone for long-term maintenance of normal sinus rhythm in patients with recurrent symptomatic atrial fibrillation
2004, American Journal of Cardiology