Randomised controlled trials (RCTs) that compared pill-in-the-pocket strategy (single oral dose) with episodic in-hospital treatment (propafenone, flecainide, beta-blockers, sotalol and amiodarone) or continuous prophylactic antiarrhythmic drug therapy (propafenone, flecainide, beta blockers sotalol and amiodarone) in patients with paroxysmal atrial fibrillation were eligible for inclusion. RCTs that provided data only on a subgroup of their recruited patients were excluded. The eligible secondary comparator was radiofrequency ablation. The review outcomes were mean time to conversion and conversion rates (both of which were measured from atrial fibrillation to normal sinus rhythm) and number of hospital visits.
None of the identified studies compared pill-in-the-pocket strategy with any other treatment. Twelve RCTs identified were relevant to the decision problem as these included relevant drugs for treating paroxysmal atrial fibrillation. Drugs assessed included flecainide, propafenone, digoxin-quinidine and sotalol administered orally or intravenously. Where reported, follow-up ranged from two to 89 hours in most studies; one study reported a mean follow-up of 15 months. Studies were conducted in a hospital setting and published between 1988 and 2004.
Two reviewers independently assessed studies for inclusion.