Arch Intern Med
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Randomized Controlled Trial Clinical Trial
The efficacy of intravenous amiodarone for the conversion of chronic atrial fibrillation. Amiodarone vs quinidine for conversion of atrial fibrillation.
Chronic atrial fibrillation (CAF) is a serious condition with significant morbidity and mortality. The mainstay of drug therapy for the conversion of atrial fibrillation to sinus rhythm continues to be quinidine. The value and safety of intravenously (i.v.) administered amiodarone therapy vs quinidine sulfate therapy was compared in a cohort of patients with CAF of more than 3 weeks' duration. ⋯ During the first 48 hours of treatment, i.v. amiodarone and oral quinidine were equally effective in converting CAF to sinus rhythm. At 2 and 9 months of therapy, treatment with oral amiodarone was superior to that of quinidine in restoring sinus rhythm. Long-term treatment with oral amiodarone is better tolerated than with quinidine.
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Because of their universal use by medical professionals, stethoscopes can be a source of nosocomial infections. ⋯ Stethoscope use may be important in the spread of infectious agents, including antimicrobial-resistant strains, and strategies to reduce the contamination of stethoscopes should be developed. We recommend disinfection of stethoscopes or regular use of disposable stethoscope covers.