Propafenone or sotalol? Choice of antiarrhythmic drug in real clinical practice

Cover Page

Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

In clinical practice, a cardiologist, therapist, general practitioner meets daily with patients with cardiac arrhythmias. The management of these patients depends on the type of arrhythmia and the presence of severe organic heart disease. It is not an easy decision to choose the safest and most effective antiarrhythmic drug. The most commonly prescribed drugs in this group are propafenone and sotalol. The article provides an overview of the use of these drugs for various types of cardiac arrhythmias.

Full Text

Restricted Access

About the authors

Andrey V. Syrov

Peoples’ Friendship University of Russia

Author for correspondence.
Email: syrman2002_1@yahoo.com
ORCID iD: 0000-0002-2536-5781

phd in medical sciences, associate professor of the department of general medical practice 

Russian Federation, 117198, Moscow, 6 Miklukho-Maklaya Str.

References

  1. Клинические рекомендации. Фибрилляция и трепетание предсердий у взрослых. Общероссийская общественная организация «Российское кардиологическое общество», Всероссийское научное общество специалистов по клинической электрофизиологии, аритмологии и электростимуляции, Ассоциация сердечно-сосудистых хирургов России. Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 382. Доступ: https://cr.minzdrav.gov.ru/schema/382_1 (дата обращения – 01.08.2023). [Clinical guidelines. Atrial fibrillation and flutter in adults. Russian Society of Cardiology, All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Electrical Stimulation, Association of Cardiovascular Surgeons of Russia. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 382.
  2. URL: https://cr.minzdrav.gov.ru/schema/382_1 (date of access – 01.08.2023) (In Russ.)].
  3. European Society of Cardiology. 2020 guidelines for of atrial fibrillation. ESC clinical practice guidelines. URL: https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Atrial-Fibrillation-Management (date of access – 01.09.2023).
  4. Vaughan Williams E.M. A classification of antiarrhythmic actions reassessed after a decade of new drugs. J Clin Pharmacol. 1984; 24(4): 129–47. https://dx.doi.org/10.1002/j.1552-4604.1984.tb01822.x.
  5. Официальные инструкции по применению лекарственных препаратов с МНН пропафенон. Государственный реестр лекарственных средств Минздрава России. Доступ: https://grls.rosminzdrav.ru/ (дата обращения – 01.09.2023). [Official instructions for the use of drugs with INN propaphenone. State Register of Medicines of the Ministry of Healthcare of Russia.
  6. URL: https://grls.rosminzdrav.ru/ (date of access – 01.09.2023) (In Russ.)].
  7. RxList. Propafenone.
  8. URL: https://www.rxlist.com/consumer_propafenone_rythmol_rythmol_sr/drugs-condition.htm (date of access – 01.09.2023).
  9. Valembois L., Audureau E., Takeda A. et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2019; 9(9): CD005049. https://dx.doi.org/10.1002/14651858.CD005049.pub5.
  10. Lafuente-Lafuente C., Longas-Tejero M., Bergmann J., Belmin J. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2012; (5): CD005049. https://dx.doi.org/10.1002/14651858.CD005049.pub3.
  11. Официальные инструкции по применению лекарственных препаратов с МНН соталол. Государственный реестр лекарственных средств Минздрава России. Доступ: https://grls.rosminzdrav.ru/ (дата обращения – 01.09.2023). [Official instructions for the use of drugs with INN sotalol. State Register of Medicines of the Ministry of Healthcare of Russia.
  12. URL: https://grls.rosminzdrav.ru/ (date of access – 01.09.2023) (In Russ.)].
  13. RxList. Sotalol. URL: https://www.rxlist.com/consumer_sotalol_betapace/drugs-condition.htm (date of access – 01.09.2023).
  14. Dewland T.A., Vittinghoff E., Mandyam M.C. et al. Atrial ectopy as a predictor of incident atrial fibrillation: A cohort study. Ann Intern Med. 2013; 159(11): 721–28. https://dx.doi.org/10.7326/0003-4819-159-11-201312030-00004.
  15. Gladstone D.J., Dorian P., Spring M. et al. Atrial premature beats predict atrial fibrillation in cryptogenic stroke: Results from the EMBRACE trial. Stroke. 2015; 46(4): 936–41. https://dx.doi.org/10.1161/STROKEAHA.115.008714.
  16. Deyell M.W., Park K.M., Han Y. et al. Predictors of recovery of left ventricular dysfunction after ablation of frequent ventricular premature depolarizations. Heart Rhythm. 2012; 9(9): 1465–72. https://dx.doi.org/10.1016/j.hrthm.2012.05.019.
  17. Priori S.G., Blomstrom-Lundqvist C., Mazzanti A. et al. 2015 ESC Guidelines for the management of patients with ventricular arrhythmias and the prevention of sudden cardiac Death. The Task Force for the Management of Patients with Ventricular Arrhythmias and the Prevention of Sudden Cardiac Death of the European Society of Cardiology (ESC). Endorsed by: Association for European Paediatric and Congenital Cardiology (AEPC). Eur Heart J. 2015; 36(41): 2793–867.
  18. https://dx.doi.org/10.1093/eurheartj/ehv316.
  19. Клинические рекомендации. Желудочковые аритмии. Минздрав России, ФГБУ «ННПЦССХ им. А.Н. Бакулева» Минздрава России, Центр хирургической и интервенционной аритмологии. 2017 г. Доступ: https://racvs.ru/clinic/files/2017/Ventricular-Arrhythmias.pdf (дата обращения – 01.09.2023). [Clinical guidelines. Ventricular arrhythmias. Ministry of Healthcare of Russia, A.N. Bakulev National Medical Research Center for Cardiovascular Surgery of the Ministry of Healthcare of Russia, Center for Surgical and Interventional Arrhythmology. 2017. URL: https://racvs.ru/clinic/files/2017/Ventricular-Arrhythmias.pdf (date of access – 01.09.2023) (In Russ.)].
  20. Лебедев Д.С., Михайлов Е.Н., Неминущий Н.М. с соавт. Желудочковые нарушения ритма. Желудочковые тахикардии и внезапная сердечная смерть. Клинические рекомендации 2020. Российский кардиологический журнал. 2021; 26(7): 128–189. [Lebedev D.S., Mikhailov E.N., Neminuschiy N.M. et al. Ventricular arrhythmias. ventricular tachycardias and sudden cardiac death. 2020 clinical guidelines. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2021; 26(7): 128–189 (In Russ.)].
  21. https://dx.doi.org/10.15829/1560-4071-2021-4600. EDN: HPNRIR.
  22. Saikawa T., Nakagawa M., Takahashi N. et al. The effect of propafenone on premature ventricular contractions. Jpn Heart J. 2011; 42(6): 701–11. https://dx.doi.org/10.1536/jhj.42.701.
  23. Brugada J., Katritsis D.G., Arbelo E. et al. 2019 ESC Guidelines for the management of patients with supraventricular tachycardia. The Task Force for the management of patients with supraventricular tachycardia of the European Society of Cardiology (ESC). Eur Heart J. 2020; 41(5): 655–720. https://dx.doi.org/10.1093/eurheartj/ehz467.
  24. Клинические рекомендации. Наджелудочковые тахикардии. Всероссийское научное общество специалистов по клинической электрофизиологии, аритмологии и электростимуляции, Ассоциация сердечно-сосудистых хирургов России, общероссийская общественная организация «Российское кардиологическое общество». Рубрикатор клинических рекомендаций Минздрава России. 2020. ID: 619. Доступ: https://cr.minzdrav.gov.ru/schema/619_2 (дата обращения – 01.08.2023). [Clinical guidelines. Supraventricular tachycardia. All-Russian Scientific Society of Specialists in Clinical Electrophysiology, Arrhythmology and Electrical Stimulation, Association of Cardiovascular Surgeons of Russia, Russian Society of Cardiology. Rubricator of clinical guidelines of the Ministry of Healthcare of Russia. 2020. ID: 619.
  25. URL: https://cr.minzdrav.gov.ru/schema/619_2 (date of access – 01.08.2023) (In Russ.)].
  26. Caldeira D., David C., Sampaio C. Rate versus rhythm control in atrial fibrillation and clinical outcomes: Updated systematic review and meta-analysis of randomized controlled trials. Arch Cardiovasc Dis. 2012; 105(4): 226–38.
  27. https://dx.doi.org/10.1016/j.acvd.2011.11.005.
  28. Carlsson J., Miketic S., Windeler J. et al.; STAF Investigators. Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation: The Strategies of Treatment of Atrial Fibrillation (STAF) study. J Am Coll Cardiol. 2003; 41(10): 1690–96.
  29. https://dx.doi.org/10.1016/s0735-1097(03)00332-2.
  30. Hohnloser S., Kuck K., Lilienthal J. Rhythm or rate control in atrial fibrillation – Pharmacological Intervention in Atrial Fibrillation (PIAF): A randomised trial. Lancet. 2000; 356(9244): 1789–94. https://dx.doi.org/10.1016/s0140-6736(00)03230-x.
  31. Karamichalakis N., Letsas K., Vlachos K. et al. Managing atrial fibrillation in the very elderly patient: Challenges and solutions. Vasc Health Risk Manag. 2015; 11: 555–62. https://dx.doi.org/10.2147/VHRM.S83664.
  32. Alboni P., Botto G.L., Baldi N. et al. Outpation treatment of recent-onset atrial fibrillation with the «pill in pocket» approach. N Engl J Med. 2004; 351(23): 2384–91. https://dx.doi.org/10.1056/NEJMoa041233.
  33. [Antonelli D., Darawsha A., Rimbrot S. at al. Propafenone dose for emergency room conversion of paroxysmal atrial fibrillation. Harefuah. 1999; 136(11): 857–59, 915 (In Hebrew)].
  34. Azpitarte J., Alvarez M., Baun O. et al. Value of single oral loading dose of propafenone in converting recent-onset atrial fibrillation. Results of a randomized, double-blind, controlled study. Eur Heart J. 1997; 18(10): 1649–54.
  35. https://dx.doi.org/10.1093/oxfordjournals.eurheartj.a015146.
  36. Boriani G., Capucci A., Lenzi T. et al. Propafenone for conversion of recent-onset atrial fibrillation. A controlled comparison between oral loading dose and intravenous administration. Chest. 1995; 108(2): 355–58. https://dx.doi.org/10.1378/chest.108.2.355.
  37. Boriani G., Biffi M., Capucci A. et al. Oral loading with propafenone: A placebo-controlled study in elderly and nonelderly patients with recent onset atrial fibrillation. Pacing Clin Electrophysiol. 1998; 21(11Pt2): 2465–69.
  38. https://dx.doi.org/10.1111/j.1540-8159.1998.tb01202.x.
  39. Blanc J., Voinov C., Maarek M. Comparison of oral loading dose of propafenone and amiodarone for converting recent-onset atrial fibrillation. PARSIFAL Study Group. Am J Cardiol. 1999; 84(9): 1029–32. https://dx.doi.org/10.1016/s0002-9149(99)00493-2.
  40. Botto G., Capucci A., Bonini W. at al. Conversion of recent onset atrial fibrillation to sinus rhythm using a single oral loading dose of propafenone: Comparison of two regimens. Int J Cardiol. 1997; 58(1): 55–61. https://dx.doi.org/10.1016/s0167-5273(96)02841-0.
  41. Capucci A., Villiani G., Aschieri D. Safety of oral propafenone in the convertion of recept-onset atrial fibrillation to sinus rhythm:
  42. a prospective parallel placebo – controlled multicentred study. Int J Cardiol. 1999; 68(2): 187–96.
  43. https://dx.doi.org/10.1016/s0167-5273(98)00363-5.
  44. Deneer V., Borgh M., Kingma J. et al. Oral antiarrhythmic drugs in converting recent onset atrial fibrillation. Pharm World Sci. 2004; 26(2): 66–78. https://dx.doi.org/10.1023/b:phar.0000018593.02291.c0.
  45. Fresco C., Proclemer A., Pavan A. et al. Intravenous propafenone in paroxysmal atrial fibrillation: a randomized, placebo-controlled, double-blind, multicenter clinical trial. Paroxysmal Atrial Fibrillation Italian Trial (PAFIT)-2 Investigators. Clin Cardiol. 1996; 19(5): 409–12. https://dx.doi.org/10.1002/clc.4960190515.
  46. Khan I. Single oral loading dose of propafenone for pharmacological cardioversion of recent-onset atrial fibrillation. J Am Coll Cardiol. 2001; 37(2): 542–47. https://dx.doi.org/10.1016/s0735-1097(00)01116-5.
  47. Martignani C., Diemberger I., Ziacchi M. et al. Oral loading of propafenone: Restoring its role before restoring rhythm. Europace. 2017; 19(11): 1903. https://dx.doi.org/10.1093/europace/euw264.
  48. Meinertz T., Lip G., Lombardi F. et al.; ERAFT Investigators. Efficacy and safety of propafenone sustained release in the prophylaxis of symptomatic paroxysmal atrial fibrillation (The European Rythmol/Rytmonorm Atrial Fibrillation Trial [ERAFT] Study). Am J Cardiol. 2002; 90(12): 1300–6. https://dx.doi.org/10.1016/s0002-9149(02)02867-9.
  49. Porterfield J., Porterfield L. Therapeutic efficacy and safety of oral propafenone for atrial fibrillation. Am J Cardiol. 1989; 63(1): 114–16. https://dx.doi.org/10.1016/0002-9149(89)91091-6.
  50. [Satullo G., Arrigo F., Cavallaro L. et al. A comparison between propafenone and hydroquinidine perorally in the treatment of recent-onset atrial fibrillation. Minerva Cardioangiol. 1996; 44(3): 141–44 (In Italian)].
  51. Лукьянова И.Ю., Кузнецов А.В., Комарницкий В.М., Козырева А.Г. Изучение эффективности и безопасности препаратов для медикаментозной кардиоверсии у больных с пароксизмальной формой фибрилляции предсердий на догоспитальном этапе. Скорая медицинская помощь. 2017; 18(4): 43–47. [Lukianova I.Yu., Kuzneztov A.V., Komarnitsky V.M., Kozyreva A.G. Medication for pharmacological cardioversion of paroxysmal atrial fibrillation at the prehospital stage: Study of efficacy and safety. Skoraya meditsinskaya pomoshch’ = Emergency Medical Care. 2017; 18(4): 43–47 (In Russ.)].
  52. https://dx.doi.org/10.24884/2072-6716-2017-18-4-43-47. EDN: ZXPLQJ.
  53. Фомина И.Г., Тарзиманова А.И., Вертлужский А.В. с соавт. Пропафенон при восстановлении синусового ритма у больных с персистирующей формой фибрилляции предсердий. «ПРОМЕТЕЙ» – открытое, мультицентровое, пилотное исследование в Российской Федерации (часть II). Кардиоваскулярная терапия и профилактика. 2005; 4(5): 62–65. [Fomina I.G., Tarzimanova A.I., Vetluzhsky A.V. et al. Propafenone in restoring sinus rhythm among patients with persistent atrial fibrillation. PROMETEY – an open, multicenter, pilot study performed in the Russian Federation (part II). Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2005; 4(5): 62–65 (In Russ.)]. EDN: HWESHN.
  54. Antonelli D., Freedberg N.A., Feldman A. et al. Intravenous propafenone for conversion of atrial fibrillation in the emergency room. Harefuah. 2004; 143(7): 471–74, 551, 552 (In Hebrew)].
  55. [Cointe R., Metge M., Bru P. et al. Intravenous and oral propafenone in the treatment and prevention of paroxysmal atrial fibrillation. Ann Cardiol Angeiol. 1993; 42(4): 223–27 (In French)].
  56. Capucci A., Boriani G. Intravenous administration of propafenone. J Am Coll Cardiol. 1992; 19(6): 1368–69.
  57. https://dx.doi.org/10.1016/0735-1097(92)90350-v.
  58. [Carerj S., Cavalli G., Magazu A. et al. Treatment of recent atrial fibrillation with intravenous propafenone. Cardiologia. 1989; 34(1): 83–85 (In Italian)].
  59. Goy J., Metrailler J., Humair L., de Torrente A. Restoration of sinus rhythm in atrial fibrillation of recent onset using intravenous propafenone. Am Heart J. 1991; 122(6): 1788–90. https://dx.doi.org/10.1016/0002-8703(91)90306-3.
  60. Haefeli E.W., Vozeh S., Ha H.R., Follath F. Comparison of the pharmacodynamic effects of intravenous and oral propafenone.
  61. Clin Pharmacol Ther. 1990; 48(3): 245–54. https://dx.doi.org/10.1038/clpt.1990.146.
  62. Liguori A., di Ieso N., D’Armiento F. et al. Intravenous propafenone for suppression of symptomatic atrial fibrillation and atrial flutter in a first aid hospital. Riv Eur Sci Med Farmacol. 1992; 14(4): 229–32.
  63. Madonia S., De Simone M., Brai G. et al. Intravenous versus oral initial load of propafenone for conversion of recent-onset atrial fibrillation in the emergency room: A randomized trial. Ital Heart J. 2000; 1(7): 475–79.
  64. Margheri M., Fradella G., Maioli M. et al. Efficacy of intravenous and per os propafenone in the ambulatory treatment of recent-onset atrial fibrillation. G Ital Cardiol. 1992; 22(3): 257–65.
  65. Velazquez Rodriguez E., Cancino Rodriguez C., Arias Estrada S. et al. Pharmacological cardioversion with intravenous propafenone in atrial fibrillation. Arch Inst Cardiol Mex. 2000; 70(2): 160–66.
  66. Zadura M., Grossmann G., Modrzewska A. et al. Comparison of efficacy, safety and cost-effectiveness of intravenous versus oral propafenone in paroxysmal atrial fibrillation. Pol Merkur Lekarski. 2001; 11(62): 137–39.
  67. Тарасов А.В., С.А.Косых С.А., Бушуева Е.В. с соавт. Сравнение эффективности инъекционных форм антиаритмических препаратов пропафенона и амиодарона при проведении фармакологической кардиоверсии пароксизмальной фибрилляции предсердий. Consilium Medicum. 2019; 21(1): 81–86. [Tarasov A.V., Kosykh S.A., Bushueva E.V. et al. Comparison of antiarrhythmic medications propafenone and amiodarone injection forms effectiveness in medicamentous cardioversion of paroxysmal atrial fibrillation. Consilium Medicum. 2019; 21(1): 81–86 (In Russ.)]. https://dx.doi.org/10.26442/20751753.2019.1.190286. EDN: ZFHBML.
  68. Antman E.M., Beamer A.D., Cantillon C. et al. Long-term oral propafenone therapy for suppression of refractory symptomatic atrial fibrillation and atrial flutter. J Am Coll Cardiol. 1988; 12(4): 1005–11. https://dx.doi.org/10.1016/0735-1097(88)90468-8.
  69. Fetsch T., Bauer P., Engberding R. et al.; Prevention of Atrial Fibrillation after Cardioversion Investigators. Prevention of atrial fibrillation after cardioversion: Results of the PAFAC trial. Eur Heart J. 2004; 25(16): 1385–94.
  70. https://dx.doi.org/10.1016/j.ehj.2004.04.015.
  71. Kowey P.R., Yannicelli D., Amsterdam E.; COPPA-II Investigators. Effectiveness of oral propafenone for the prevention of atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2004; 94(5): 663–65. https://dx.doi.org/10.1016/j.amjcard.2004.05.038.
  72. Миллер О.Н., Старичков С.А., Поздняков Ю.М. с соавт. Эффективность и безопасность применения пропафенона (Пропанорма®) и амиодарона (Кордарона®) у больных с фибрилляцией предсердий на фоне артериальной гипертонии, ишемической болезни сердца и хзонической сердечной недостаточности с сохраненной систолической функцией левого желудочка. Российский кардиологический журнал. 2010; 15(4): 55–71. [Miller O.N., Starichkov S.A., Pozdnyakov Yu.M. et al. Effectiveness and safety of propafenone (Propanorm®) and amiodarone (Cordarone®) in patients with atrial fibrillation, arterial hypertension, coronary heart disease, and chronic heart failure with intact left ventricular systolic function. Rossiyskiy kardiologicheskiy zhurnal = Russian Journal of Cardiology. 2010; 15(4): 55–71 (In Russ.)]. EDN: MUENJV.
  73. Gomes J.A., Ip J., Santoni-Rugiu F. et al. Oral d, l sotalol reduces the incidence of postoperative atrial fibrillation in coronary artery bypass surgery patients: A randomized, double-blind, placebo-controlled study. J Am Coll Cardiol. 1999; 34(2): 334–39.
  74. https://dx.doi.org/10.1016/s0735-1097(99)00213-2.
  75. Somberg J., Molnar J. Sotalol versus amiodarone in treatment of atrial fibrillation. J Atr Fibrillation. 2016; 8(5): 1359.
  76. https://dx.doi.org/10.4022/jafib.1359.
  77. Singh B.N., Singh S.N., Reda D.J. et al.; Sotalol Amiodarone Atrial Fibrillation Efficacy Trial (SAFE-T) Investigators. Amiodarone versus sotalol for atrial fibrillation. N Engl J Med. 2005; 352(18): 1861–72. https://dx.doi.org/10.1056/NEJMoa041705.
  78. Waldo A., Camm A., deRuyter H. et al. Effect of d-sotalol on mortality in patients with left ventricular dysfunction after recent and remote myocardial infarction. The SWORD Investigators. Survival with oral d-Sotalol. Lancet. 1996; 348(9019): 7–12.
  79. https://dx.doi.org/10.1016/s0140-6736(96)02149-6.
  80. Zimetbaum P.J., Josephson M.E. Amiodarone versus sotalol for atrial fibrillation. N Engl J Med. 2005; 353(6): 627–30; author reply 627–30.
  81. Оганов Р.Г., Симаненков В.И., Бакулин И.Г. с соавт. Коморбидная патология в клинической практике. Алгоритмы диагностики и лечения. Кардиоваскулярная терапия и профилактика. 2019; 18(1): 5–66. [Oganov R.G., Simanenkov V.I., Bakulin I.G. et al. Comorbidities in clinical practice. Algorithms for diagnostics and treatment. Kardiovaskulyarnaya terapiya i profilaktika = Cardiovascular Therapy and Prevention. 2019; 18(1): 5–66 (In Russ.)].
  82. https://dx.doi.org/10.15829/1728-8800-2019-1-5-66. EDN: YXKKAP.
  83. Kochiadakis G.E., Igoumenidis N.E., Hamilos M.E. et al. A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent-onset atrial fibrillation. Am J Cardiol. 2007; 99(12): 1721–25.
  84. https://dx.doi.org/10.1016/j.amjcard.2007.01.059.
  85. Bellandi F., Simonetti I., Leoncini M. et al. Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation. Am J Cardiol. 2001; 88(6): 640–45.
  86. https://dx.doi.org/10.1016/s0002-9149(01)01806-9.
  87. Fetsch T., Bauer P., Engberding R. et al.; Prevention of Atrial Fibrillation after Cardioversion Investigators. Prevention of atrial fibrillation after cardioversion: Results of the PAFAC trial. Eur Heart J. 2004; 25(16): 1385–94.
  88. https://dx.doi.org/10.1016/j.ehj.2004.04.015.
  89. Kowey P.R., Yannicelli D., Amsterdam E.; COPPA-II Investigators. Effectiveness of oral propafenone for the prevention of atrial fibrillation after coronary artery bypass grafting. Am J Cardiol. 2004; 94(5): 663–65. https://dx.doi.org/10.1016/j.amjcard.2004.05.038.
  90. Valembois L., Audureau E., Takeda A. et al. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2019; 9(9): CD005049. https://dx.doi.org/10.1002/14651858.CD005049.pub5.
  91. Lafuente-Lafuente C., Longas-Tejero M., Bergmann J., Belmin J. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2012; 5: CD005049. https://dx.doi.org/10.1002/14651858.CD005049.pub3

Supplementary files

Supplementary Files
Action
1. JATS XML

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies