Efficacy of Sotalol and Amiodarone for Atrial Fibrillation

Abstract

Background and Objectives:Atrial fibrillation (AF) is the most frequently encountered arrhythmia in clinical practice. Pharmacologic therapy has been advocated for both the immediate restoration of sinus rhythm and the prevention of recurrent AF. Because conventional antiarrhythmic therapy is often ineffective in maintaining sinus rhythm or is associated with adverse side effects in patients with AF, recent interest has been focused on the use of class III antiarrhythmic agents. This study investigated the efficacy and safety of sotalol and amiodarone for the conversion of chronic AF and prevention of recurrent AF. Materials and Method: Thirty six patients with AF were firstly first received sotalol by prospective study protocol. The patients were classified as having paroxysmal AF (PAF, N=12) or chronic AF (CAF, N=24) based on their AF pattern. If the patients with CAF did not convert to sinus rhythm or the patients with PAF recurred in AF, the patients were received a second agentsagent (amiodarone). Patients were followed up for one year. Results:Among the 12 patients with PAF receiving sotalol, 10 (83.3%) patients remained in normal sinus rhythm for an average 9.4±3.6 months. Sotalol was replaced by amiodarone in the remaing remaining 2 patients with arrhythmia recurrence and 1 of the 2 patients remained in sinus rhythm during the follow-up period. In the case of the 24 patients with CAF, conversion to sinus rhythm was achieved in 5 (20.8%) patients with sotalol. Among the patients with CAF who were did not respond to sotalol, 17 patients received amiodarone subsquently and 3 patients successfully converted to sinus rhythm. There were no proarrhythmic effects related to both agents either agent during the study period. Conclusion:Both sotalol and amiodarone appear to be less effective in the termination of CAF, but however the sequential use of these two agents seem to be very effective for the prevention of a recurrence of PAF. (Korean Circulation J 2001;31(2):210-216)