Comparison of class III antiarrhythmic drugs versus digoxin for the reversion of new-onset atrial fibrillation

Abstract

I read with interest the article by Joseph and Ward 1 Joseph AP Ward MR. A prospective, randomized controlled trial comparing the efficacy and safety of sotalol, amiodarone, and digoxin for the reversion of new-onset atrial fibrillation. Ann Emerg Med. 2000; 36: 1-9 Abstract Full Text Full Text PDF PubMed Scopus (79) Google Scholar (article #107655) that compared, in a randomized controlled trial, the efficacy and safety of sotalol, amiodarone, and digoxin for the reversion of new-onset atrial fibrillation. After 48 hours of observation, active therapy, which included sotalol and amiodarone, had a reversion rate to sinus rhythm of 82.3% (87.5% with sotalol and 76.9% with amiodarone), which is higher than the 58.3% observed with digoxin (P <.01). To my knowledge, this is the first trial that demonstrated the efficacy of sotalol in the conversion of atrial fibrillation (P <.01 versus digoxin). No statistical difference was observed between sotalol and amiodarone or between amiodarone and digoxin. However, there are some points stated by the authors that deserve further analysis. A prospective, randomized controlled trial comparing the efficacy and safety of Sotalol, Amiodarone, and Digoxin for the reversion of new-onset atrial fibrillationAnnals of Emergency MedicineVol. 36Issue 1PreviewStudy Objective: A prospective, randomized controlled trial of new-onset atrial fibrillation was conducted to compare the efficacy and safety of sotalol and amiodarone (active treatment) with rate control by digoxin alone for successful reversion to sinus rhythm at 48 hours. Methods: We prospectively randomly assigned 120 patients with atrial fibrillation of less than 24 hours’ duration to treatment with sotalol, amiodarone, or digoxin using a single intravenous dose followed by 48 hours of oral treatment. Full-Text PDF