[Therapy of paroxysmal atrial fibrillation. Cardiac glycosides alone or combined with anti-arrhythmia agents?].

In a prospective study 45 patients with paroxysmal atrial fibrillation were randomly assigned to one of three groups (of 15 patients each): group I received oral digoxin, three times 0.125 mg up to twice 0.25 mg daily; group II oral digoxin twice 0.125 mg and quinidine hydrogen sulphate 750-1000 mg daily; group III oral digoxin three times 0.125 mg and flecainide 200-300 mg daily. During a mean observation period of 11 months digoxin alone was significantly less effective (P less than 0.05) in reducing or suppressing paroxysms of atrial fibrillation than digoxin plus quinidine or flecainide. Flecainide with digoxin was more effective than the drug regimen in groups I and II (P less than 0.05). Two patients each in groups I and III had side effects, eight in group II. The results suggest that, at the chosen dosage, flecainide produces fewer side effects than quinidine.