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Concerns that antiarrhythmic agents may cause more harm than good in many patients were raised last year when the Cardiac Arrhythmia Suppression Trial showed that flecainide and encainide increased mortality in patients with ventricular arrhythmias after acute myocardial infarction (see Journal Watch accession number 890818001). These concerns will only be heightened by this meta- analysis, which pooled data from six randomized, controlled trials of quinidine therapy for maintenance of sinus rhythm after cardioversion. The six studies included a total of 808 patients and were reported between 1970 and 1984.
The meta-analysis showed that patients treated with quinidine were twice as likely as controls to remain in sinus rhythm one year after …