Amiodarone ( Cordarone ) is more efficacy than Sotalol ( Betapace ) for maintaining sinus rhythm, but both drugs have equal efficacy in patients with ischemic heart disease.
A total of 665 patients who had persistent atrial fibrillation were randomly assigned 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.
The median time 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 analysis.
Amiodarone was more efficacy than Sotalol and placebo, and Sotalol was superior to placebo.
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.
Sustained sinus rhythm is associated with an improved quality of life and improved exercise performance.
There were no significant differences in major adverse events among the three groups.
Source: The New England Journal of Medicine, 2005