title: [Acute atrial fibrillation in the emergency room. Which is the best drug for a rapid sinus rhythm conversion?].
abstract: OBJECTIVE
  To evaluate differences between amiodarone, procainamide and quinidine in the time delay necessary to convert acute atrial fibrillation (AF) to sinus rhythm.
  
  
  METHODS
  Sixty patients with acute AF were randomized in three groups (G) and treated with: quinidine (QG)-(21 patients) i.v. digital + quinidine up to 600 mg; procainamide (PG)-(23 patients) i.v. digital + i.v. procainamide, 10 mg/kg; amiodarone (AG)-(16 patients) i.v. amiodarone, 5 mg/kg. To evaluate time delay to conversion, all patients have their rhythm recorded by Holter system during four hours. Statistics were done with x2, considering significant a p < 0.05.
  
  
  RESULTS
  There were no differences between groups regarding to age, gender and delay from symptoms initiation and medical assistance. Conversion to sinus rhythm occurred, in QG-71.4% cases; PG-47.8% and AG-50% (p > 0.05). Time delay in minutes to conversion were, respectively (media +/- SD): QG-112 +/- 43; PG-44.1 +/- 28; AG-20 +/- 13, significantly lower in PG and AG related to QG (p = 0.001). Although not significant, side effects were observed mostly in PG.
  
  
  CONCLUSIONS
  Amiodarone is a good choice to convert, very quickly, acute AF. Otherwise, quinidine has the best rate of conversion but with a longer time delay.
authors.affiliation: Instituto do Coração do Hospital das Clínicas-FMUSP.
authors.forename: L A
authors.initials: LA
authors.lastname: César
authors.forename: C V
authors.initials: CV
authors.lastname: Serrano
authors.forename: D
authors.initials: D
authors.lastname: Pamplona
authors.forename: A L
authors.initials: AL
authors.lastname: D'Avila
authors.forename: J F
authors.initials: JF
authors.lastname: Ferreira
authors.forename: R V
authors.initials: RV
authors.lastname: Amato
authors.forename: E
authors.initials: E
authors.lastname: Pfeferman
authors.forename: M
authors.initials: M
authors.lastname: Scanavacca
authors.forename: E A
authors.initials: EA
authors.lastname: Sosa
authors.forename: G
authors.initials: G
authors.lastname: Bellotti
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000188:drug therapy* / Q000503:physiopathology; D004630:Emergencies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011342:Procainamide / Q000627:therapeutic use*; D011802:Quinidine / Q000627:therapeutic use*; D012849:Sinoatrial Node / Q000187:drug effects / Q000503:physiopathology; D013997:Time Factors
chemical_list: D011802:Quinidine; D011342:Procainamide; D000638:Amiodarone