Amiodarone versus sotalol for atrial fibrillation
Open accessAbstract
BACKGROUND: The optimal pharmacologic means to restore and maintain sinus rhythm in patients with atrial fibrillation remains controversial. METHODS: In this double-blind, placebo-controlled trial, we randomly assigned 665 patients who were receiving anticoagulants and had persistent atrial fibrillation to receive amiodarone (267 patients), sotalol (261 patients), or placebo (137 patients) and monitored them for 1 to 4.5 years. The primary end point was the time to recurrence of atrial fibrillation beginning on day 28, determined by means of weekly transtelephonic monitoring. RESULTS: Spontaneous conversion occurred in 27.1 percent of the amiodarone group, 24.2 percent of the sotalol group, and 0.8 percent of the placebo group, and direct-current cardioversion failed in 27.7 percent, 26.5 percent, and 32.1 percent, respectively. The median times to a recurrence of atrial fibrillation were 487 days in the amiodarone group, 74 days in the sotalol group, and 6 days in the placebo group according to intention to treat and 809, 209, and 13 days, respectively, according to treatment received. Amiodarone was superior to sotalol (P<0.001) and to placebo (P<0.001), and sotalol was superior to placebo (P<0.001). In patients with ischemic heart disease, the median time to a recurrence of atrial fibrillation was 569 days with amiodarone therapy and 428 days with sotalol therapy (P=0.53). Restoration and maintenance of sinus rhythm significantly improved the quality of life and exercise capacity. There were no significant differences in major adverse events among the three groups. CONCLUSIONS: Amiodarone and sotalol are equally efficacious in converting atrial fibrillation to sinus rhythm. Amiodarone is superior for maintaining sinus rhythm, but both drugs have similar efficacy in patients with ischemic heart disease. Sustained sinus rhythm is associated with an improved quality of life and improved exercise performance.
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d,l-Sotalol has been used in atrial fibrillation patients without safety signals in two controlled trials.
“On the other hand, d,l sotalol has been used in AF patients without safety signals in two controlled trials. 581,60101”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [601]
ECG monitoring was used systematically on days 1-3 in patients receiving flecainide, propafenone, or sotalol to identify those at risk of proarrhythmia.
“ECG monitoring was used systematically on days 1-3 in patients receiving flecainide, propafenone, or sotalol to identify those at risk of proarrhythmia.118,584,601”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [601]
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Cites
Prediction of Creatinine Clearance from Serum Creatinine
Cockcroft, D. W., & Gault, H. (2008) · The Nephron journals/Nephron journals · doi:10.1159/000180580 · Cited by 15,291 · see citing works
MCHORNEY, C. A., JOHNE, W., & ANASTASIAE, R. (1993) · Medical Care · doi:10.1097/00005650-199303000-00006 · Cited by 6,681 · see citing works
Go, A. S., Hylek, E. M., Phillips, K. A., Chang, Y., Henault, L. E., Selby, J. V., & Singer, D. E. (2001) · JAMA · doi:10.1001/jama.285.18.2370 · Cited by 6,205 · see citing works
A comparison of rate control and rhythm control in patients with atrial fibrillation
(2002) · New England Journal of Medicine · doi:10.1056/nejmoa021328 · Cited by 4,405 · see citing works
Gelder, I. C. V., Hagens, V. E., Bosker, H. A., Kingma, J. H., Otto Kamp, B., Kingma, T., Said, S. A., Darmanata, J. I., Timmermans, A. J. M., Tijssen, J. G. P., et al. (2002) · New England Journal of Medicine · doi:10.1056/nejmoa021375 · Cited by 2,355 · see citing works
Stewart, A. L. (1989) · JAMA · doi:10.1001/jama.262.7.907 · Cited by 2,095 · see citing works
Amiodarone in Patients with Congestive Heart Failure and Asymptomatic Ventricular Arrhythmia
Singh, S. N., Fletcher, R. D., Fisher, S. G., Singh, B. N., Lewis, H. D., DEEDWANIA, P. C., Massie, B. M., Colling, C. L., & Lazzeri, D. (1995) · New England Journal of Medicine · doi:10.1056/nejm199507133330201 · Cited by 1,217 · see citing works
Self-citationAmiodarone to Prevent Recurrence of Atrial Fibrillation
Roy, D., Talajic, M. R., Dorian, P., Connolly, S. J., Eisenberg, M. J., Green, M. S., Kuś, T., Lambert, J., Dubuc, M., Gagné, P., et al. (2000) · New England Journal of Medicine · doi:10.1056/nejm200003303421302 · Cited by 1,142 · see citing works
Hohnloser, S. H., Kück, K., & Lilienthal, J. (2000) · The Lancet · doi:10.1016/s0140-6736(00)03230-x · Cited by 1,132 · see citing works
Randomised trial of low-dose amiodarone in severe congestive heart failure
Doval, H., Nul, D. R., Grancelli, H., Perrone, S. V., Bortman, G., & Curiel, R. (1994) · The Lancet · doi:10.1016/s0140-6736(94)91895-3 · Cited by 913 · see citing works
Management of Patients With Atrial Fibrillation
Prystowsky, E. N., Benson, D. W., Fuster, V., Hart, R. G., Kay, G. N., Myerburg, R. J., Naccarelli, G. V., & Wyse, D. G. (1996) · Circulation · doi:10.1161/01.cir.93.6.1262 · Cited by 643 · see citing works
Dorian, P., Jung, W., Newman, D., Paquette, M., Wood, K., Ayers, G. M., Camm, J., Akhtar, M., & Luderitz, B. (2000) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(00)00886-x · Cited by 627 · see citing works
The effect of amiodarone, a new anti‐anginal drug, on cardiac muscle
Singh, B. N., & Williams, E. M. V. (1970) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1970.tb09891.x · Cited by 554 · see citing works
Self-citationDEEDWANIA, P. C., Singh, B. N., Ellenbogen, K. A., Fisher, S. G., Fletcher, R. D., & Singh, S. N. (1998) · Circulation · doi:10.1161/01.cir.98.23.2574 · Cited by 505 · see citing works
Self-citationEffect of rate or rhythm control on quality of life in persistent atrial fibrillation
Hagens, V. E., Ranchor, A. V., Van Sonderen, E., Bosker, H. A., Kamp, O., Tijssen, J. G. P., Kingma, J. H., Crijns, H. J. G. M., & Van Gelder, I. C. (2004) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2003.08.037 · Cited by 461 · see citing works
CONTROLLED TRIAL OF SOTALOL FOR ONE YEAR AFTER MYOCARDIAL INFARCTION
Julian, D. G., Jackson, F. S., Prescott, R. J., & Szekely, P. (1982) · The Lancet · doi:10.1016/s0140-6736(82)92225-5 · Cited by 430 · see citing works
Singh, B. N., & Williams, E. M. V. (1970) · British Journal of Pharmacology · doi:10.1111/j.1476-5381.1970.tb09893.x · Cited by 383 · see citing works
Self-citationTreadmill exercise in assessment of the functional capacity of patients with cardiac disease
Patterson, J. A., Naughton, J., Pietras, R. J., & Gunnar, R. M. (1972) · The American Journal of Cardiology · doi:10.1016/0002-9149(72)90151-8 · Cited by 303 · see citing works
Gelder, I. C. V., Crijns, H. J. G. M., Blanksma, P. K., Landsman, M. L. J., Posma, J. L., van den Berg, M. P., MEIJLER, F. L., & Lie, K. I. (1993) · The American Journal of Cardiology · doi:10.1016/0002-9149(93)90352-d · Cited by 269 · see citing works
Quality of life improves with treatment in the Canadian Trial of Atrial Fibrillation
Dorian, P., Paquette, M., Newman, D. M., Green, M. S., Connolly, S. J., Talajic, M. R., & Roy, D. (2002) · American Heart Journal · doi:10.1067/mhj.2002.122518 · Cited by 247 · see citing works
Chun, S., Sager, P. T., Stevenson, W. G., Nademanee, K., Middlekauff, H. R., & Singh, B. N. (1995) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)80799-1 · Cited by 211 · see citing works
Self-citationMcNamara, R. L., Tamariz, L. J., Segal, J. B., & Bass, E. B. (2003) · Annals of Internal Medicine · doi:10.7326/0003-4819-139-12-200312160-00012 · Cited by 211 · see citing works
Benditt, D. G., Williams, J. H. P., Jin, J., Deering, T. F., Zucker, R. P., Browne, K. F., Chang-Sing, P., & Singh, B. N. (1999) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00275-1 · Cited by 163 · see citing works
Self-citationEffects of Antiarrhythmic Drugs on Fibrillation in the Remodeled Atrium
Shinagawa, K., Shiroshita-Takeshita, A., Schram, G., & Nattel, S. (2003) · Circulation · doi:10.1161/01.cir.0000055316.35552.74 · Cited by 160 · see citing works
Frick, M., Frykman, V., Jensen‐Urstad, M., & Östergren, J. (2001) · Clinical Cardiology · doi:10.1002/clc.4960240313 · Cited by 156 · see citing works
Hohnloser, S., Kück, K., & Lilienthal, J. D. (2001) · ACC Current Journal Review · doi:10.1016/s1062-1458(01)00270-7 · Cited by 130 · see citing works
Gelder, I. C. V., Hagens, V. E., & Bosker, H. A. (2003) · ACC Current Journal Review · doi:10.1016/s1062-1458(03)00083-7 · Cited by 107 · see citing works
The Molecular and Ionic Specificity of Antiarrhythmic Drug Actions
Nattel, S. (1999) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1999.tb00673.x · Cited by 97 · see citing works
Evolution, mechanisms, and classification of antiarrhythmic drugs: focus on class III actions
Nattel, S., & Singh, B. N. (1999) · The American Journal of Cardiology · doi:10.1016/s0002-9149(99)00697-9 · Cited by 92 · see citing works
Self-citationSingh, B. N. (1999) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.1999.tb00674.x · Cited by 85 · see citing works
Self-citationLow-Dose Amiodarone Versus Sotalol for Suppression of Recurrent Symptomatic Atrial Fibrillation
KOCHIADAKIS, G. E., Igoumenidis, N. E., Marketou, M. E., Solomou, M. C., KANOUPAKIS, E. M., & Vardas, P. E. (1998) · The American Journal of Cardiology · doi:10.1016/s0002-9149(98)00078-2 · Cited by 84 · see citing works
Tsang, T. S. M., & Gersh, B. J. (2002) · The American Journal of Medicine · doi:10.1016/s0002-9343(02)01245-7 · Cited by 79 · see citing works
Neuropsychiatric Effects of Cardiovascular Drug Therapy
Keller, S., & Frishman, W. H. (2003) · Cardiology in Review · doi:10.1097/01.crd.0000053453.89776.2d · Cited by 78 · see citing works
Amiodarone: The expanding antiarrhythmic role and how to follow a patient on chronic therapy
Singh, B. N. (1997) · Clinical Cardiology · doi:10.1002/clc.4960200706 · Cited by 62 · see citing works
Self-citationSingh, S. N., Singh, B. N., Reda, D. J., Fye, C. L., Ezekowitz, M. D., Fletcher, R. D., Sharma, S. C., Atwood, J. E., Jacobson, A. K., Lewis, H. D., et al. (2003) · The American Journal of Cardiology · doi:10.1016/s0002-9149(03)00671-4 · Cited by 49 · see citing works
Self-citationThe effect of cardioversion on exercise capacity in patients with atrial fibrillation
Ueshima, K., MYERS, J. N., Morris, C. K., et al. (1993) · American Heart Journal · doi:10.1016/0002-8703(93)90732-o · Cited by 42 · see citing works
Persistent atrial fibrillation: a population based study of patients with their first cardioversion
Lehto, M., & Kala, R. (2003) · International Journal of Cardiology · doi:10.1016/s0167-5273(03)00099-8 · Cited by 27 · see citing works
Singh, B. N. (2003) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/107424840300800103 · Cited by 24 · see citing works
Self-citationReview : Sotalol: Current Status and Expanding Indications
Singh, B. N. (1999) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/107424849900400108 · Cited by 19 · see citing works
Self-citationSingh, B. N. (2002) · Journal of Cardiovascular Pharmacology and Therapeutics · doi:10.1177/107424840200700301 · Cited by 8 · see citing works
Self-citation
Flagged first, then by citations
Research works printed but not linked: 2
- Benditt DG, Williams JH, Jin J, et al. Maintenance of sinus rhythm with oral d,l-sotalol therapy in patients with sympto- matic atrial fibrillation and/or atrial flutter. Am J Cardiol 1999;84:270-7.
- Roy D, Talajic M, Dorian P, et al. Amio- darone to prevent recurrence of atrial fibril- lation. N Engl J Med 2000;342:913-20.
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Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Heart Journal · doi:10.1093/eurheartj/ehw210 · Cited by 6,418 · see citing works
Self-citationPriori, S. G., Blomström-Lundqvist, C., Mazzanti, A., Blom, N., Borggrefe, M., Camm, J., Elliott, P. M., Fitzsimons, D., Hatala, R., Hindricks, G., et al. (2015) · European Heart Journal · doi:10.1093/eurheartj/ehv316 · Cited by 3,893 · see citing works
2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., Conti, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2014.03.022 · Cited by 2,955 · see citing works
Self-citationFuster, V., Rydén, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Le Heuzey, J.-Y., Kay, G. N., Lowe, J. E., et al. (2006) · Circulation · doi:10.1161/circulationaha.106.177292 · Cited by 2,805 · see citing works
January, C. T., Wann, L. S., Alpert, J. S., Calkins, H., Cigarroa, J. E., Cleveland, J. C., Conti, J. B., Ellinor, P. T., Ezekowitz, M. D., Field, M. E., et al. (2014) · Circulation · doi:10.1161/cir.0000000000000040 · Cited by 2,056 · see citing works
Self-citation2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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Self-citation2023 ACC/AHA/ACCP/HRS Guideline for the Diagnosis and Management of Atrial Fibrillation
Joglar, J. A., Chung, M. K., Armbruster, A. L., Benjamin, E. J., Chyou, J. Y., Cronin, E. M., Deswal, A., Eckhardt, L. L., Goldberger, Z. D., Gopinathannair, R., et al. (2024) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2023.08.017 · Cited by 933 · see citing works
Fuster, V., Rydén, L. E., Cannom, D. S., Crijns, H. J., Curtis, A. B., Ellenbogen, K. A., Halperin, J. L., Kay, G. N., Le Huezey, J.-Y., Lowe, J. E., et al. (2011) · Circulation · doi:10.1161/cir.0b013e318214876d · Cited by 859 · see citing works
Calkins, H., Reynolds, M. R., Spector, P., Sondhi, M., Xu, Y., Martin, A., Williams, C. J., & Sledge, I. (2009) · Circulation Arrhythmia and Electrophysiology · doi:10.1161/circep.108.824789 · Cited by 847 · see citing works
Wizemann, V., Tong, L., Satayathum, S., Disney, A., Akiba, T., Fissell, R. B., Kerr, P. G., Young, E. W., & Robinson, B. M. (2010) · Kidney International · doi:10.1038/ki.2009.477 · Cited by 408 · see citing works
Kirchhof, P., Auricchio, A., Bax, J., Crijns, H., Camm, J., Diener, H.-C., Goette, A., Hindricks, G., Hohnloser, S., Kappenberger, L., et al. (2007) · Europace · doi:10.1093/europace/eum191 · Cited by 293 · see citing works
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Lip, G. Y., & Tse, H.-F. (2007) · The Lancet · doi:10.1016/s0140-6736(07)61300-2 · Cited by 229 · see citing works
Rate- and Rhythm-Control Therapies in Patients With Atrial Fibrillation: A Systematic Review
Al-Khatib, S. M., Allen LaPointe, N. M., Chatterjee, R., Crowley, M. J., Dupre, M. E., Kong, D. F., Lopes, R. D., Povsic, T. J., Raju, S. S., Shah, B., et al. (2014) · Annals of Internal Medicine · doi:10.7326/m13-1467 · Cited by 178 · see citing works
Kirchhof, P., Andresen, D., Bosch, R., Borggrefe, M., Meinertz, T., Parade, U., Ravens, U., Samol, A., Steinbeck, G., Treszl, A., et al. (2012) · The Lancet · doi:10.1016/s0140-6736(12)60570-4 · Cited by 176 · see citing works
Kirchhof, P., Breithardt, G., Camm, A. J., Crijns, H. J., Kuck, K.-H., Vardas, P., & Wegscheider, K. (2013) · American Heart Journal · doi:10.1016/j.ahj.2013.05.015 · Cited by 155 · see citing works
Kirchhof, P., Breithardt, G., Aliot, E., Al Khatib, S., Apostolakis, S., Auricchio, A., Bailleul, C., Bax, J., Benninger, G., Blomstrom-Lundqvist, C., et al. (2013) · Europace · doi:10.1093/europace/eut232 · Cited by 141 · see citing works
Siu, C.-W., Lau, C.-P., Lee, W.-L., Lam, K.-F., & Tse, H.-F. (2009) · Critical Care Medicine · doi:10.1097/ccm.0b013e3181a02f56 · Cited by 96 · see citing works
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Levin, M. D., Lu, M. M., Petrenko, N. B., Hawkins, B. J., Gupta, T. H., Lang, D., Buckley, P. T., Jochems, J., Liu, F., Spurney, C. F., et al. (2009) · Journal of Clinical Investigation · doi:10.1172/jci39109 · Cited by 92 · see citing works
Ahmed, S., Van Gelder, I. C., Wiesfeld, A. C. P., Van Veldhuisen, D. J., & Links, T. P. (2011) · Clinical Endocrinology · doi:10.1111/j.1365-2265.2011.04087.x · Cited by 72 · see citing works
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LURIA, D. M., HODGE, D. O., MONAHAN, K. H., HAROLDSON, J. M., SHEN, W., ASIRVATHAM, S. J., HAMMILL, S. C., MUNGER, T. M., GLIKSON, M., GERSH, B. J., et al. (2008) · Journal of Cardiovascular Electrophysiology · doi:10.1111/j.1540-8167.2008.01206.x · Cited by 34 · see citing works
- Authors
- Singh, B. N., Singh, S. N., Reda, D. J., Tang, X. C., Lopez, B., Harris, C. L., Fletcher, R. D., Sharma, S. C., Atwood, J. E., Jacobson, A. K., Lewis, H. D., Raisch, D. W., & Ezekowitz, M. D.
- Affiliations
- VA West Los Angeles Medical Center (US)
- United States Department of Veterans Affairs (US)
- Veterans Health Administration (US)
- Providence VA Medical Center (US)
- Walter Reed National Military Medical Center (US)
- Hahnemann University Hospital (US)
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2005-05-05
- Volume
- 352
- Issue
- 18
- Pages
- 1861-1872
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W2166887354
- Cited by
- 749
- References
- 41
- Citations by year
- 2026: 16 · 2025: 15 · 2024: 22 · 2023: 16 · 2022: 24 · 2021: 25 · 2020: 33 · 2019: 17 · 2018: 24 · 2017: 25 · 2016: 39 · 2015: 38 · 2014: 40 · 2013: 33 · 2012: 33
- FWCI
- 41.57
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Atrial Fibrillation Management and Outcomes
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Keywords
- amiodarone, sotalol, atrial fibrillation, sinus rhythm restoration, sinus rhythm maintenance, atrial fibrillation recurrence, antiarrhythmic drugs, ischemic heart disease, quality of life, exercise capacity, transtelephonic monitoring
- MeSH terms
- Aged, Amiodarone, Anti-Arrhythmia Agents, Atrial Fibrillation, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Quality of Life, Sotalol, Exercise Tolerance, Myocardial Ischemia, Disease-Free Survival, Secondary Prevention
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