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Pharmacologic therapy with Class I antiarrhythmic agents for conversion of atrial fibrillation is complicated by potential proarrhythmic effects. This randomized German study compared quinidine with sotalol, a new beta-blocker with Class III antiarrhythmic properties.
Fifty patients (mean age, 62) with a two-day to six-month history of atrial fibrillation were treated with digoxin and anticoagulants for at least eight days, then randomized to one of the two agents. Patients randomized to quinidine were given a 200 mg test dose followed by a slow release preparation (500 mg twice daily for three days); if this was ineffective, 250 mg with 80 mg of verapamil were given four times daily for the next four days. Patients taking sotalol received a…