To the Editor: As Dr Wilber and colleagues1 noted, studies suggest that among patients with paroxysmal or short-duration persistent AF who have had limited prior drug exposure, 20% to 40% of patients treated with class I drugs or sotalol and 60% to 70% of patients treated with amiodarone have no recurrence of atrial fibrillation at 1 year.2 Even though the authors stated that doses of the ADT used in their study were titrated, the actual dosages of the drugs were not given. Inadequate dosing could be a reason for a low rate of success in the ADT group in their study.
Paydak H, Mehta JL. Antiarrhythmic Drug Therapy vs Catheter Ablation for Paroxysmal Atrial Fibrillation. JAMA. 2010;303(18):1808-1810. doi:10.1001/jama.2010.537