The efficacy of quinidine and disopyramide in the maintenance of sinus rhythm after electroconversion from atrial fibrillation. A double-blind study comparing quinidine, disopyramide and placebo

In order to compare the relative efficacy of quinidine, disopyramide and a placebo in the maintenance of sinus rhythm after cardioversion from atrial fibrillation and in order to examine the incidence of side-effects, 82 patients with continuous atrial fibrillation (duration more than 1 month but less that 3 years) were randomized in a double-blind fashion to receive quinidine, disopyramide or placebo. Six months after cardioversion there was no significant difference between any of the three groups as regards the number of patients remaining in sinus rhythm. The greater distortion of the atrial architecture which occurs in patients with rheumatic mitral valve disease may explain the failure of these anti-arrhythmic agents to prolong the duration of sinus rhythm in this study, in which patients with valvular heart disease comprised 76% of the total group.