Antiarrhythmic drugs administered before inclusion in the study were discontinued five half-lives before cardioversion. DC cardioversion was started on a low energy level of 2 J/kg body weight and, if necessary repeated on full energy (350 J). Randomization to antiarrhythmic therapy: After conversion to sinus rhythm patients were observed for 2 h. If no exclusion criteria appeared, patients were randomized to open treatment with either disopyramide 200 mg for the first dose followed by three to four times 100 mg/day; propafenone three times 150 to 300 mg/day; or sotalol twice 80 to 160 mg/day. Drug assignment was provided in sealed envelopes. Other antiarrhythmic agents apart from digitalis and beta-blocking agents were not allowed as concomitant medication.
Patient records were scanned for the following clinical data: age, sex, duration of AF, history of hypertension, ischemic heart disease or congestive heart failure, and di-goxin or beta-blocker therapy. Left atrial anteroposterior size and left diastolic diameter of left ventricle were determined from M-mode echocardiographic tracing by an experienced echocardiographer.
Follow-up visit schedule: Follow-up visits were scheduled at one week and at one, three, six and 12 months after DC if sinus rhythm was maintained. An electrocardiogram (ECG) was recorded before and after conversion to sinus rhythm and during follow-up visits. Twenty-four hour Holter monitoring was done at one week and at six months after conversion to sinus rhythm. Duration of sinus rhythm was measured from the date of DC cardioversion to the first electrocardiographi-cally documented recurrence of AF.
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