Which drug is most likely to maintain sinus rhythm following successful DC cardioversion in a patient with atrial fibrillation?

Amiodarone is recognized for its efficacy in maintaining sinus rhythm after successful DC cardioversion in patients with atrial fibrillation. It is a class III antiarrhythmic medication that works primarily by prolonging the action potential duration and refractory period in cardiac tissue, which helps to stabilize the heart rhythm and prevent the recurrence of atrial fibrillation.

This drug is often preferred in clinical practice due to its well-established efficacy in both rhythm control and rate control, especially in patients who have structural heart disease or heart failure, conditions in which other antiarrhythmic agents may be less effective or may carry greater risks of adverse effects.

Additionally, amiodarone has a relatively longer half-life, which contributes to its sustained effect in maintaining sinus rhythm after cardioversion. Other medications, while they may have roles in controlling heart rate and rhythm, do not have the same level of effectiveness in preventing recurrence after cardioversion.

Digoxin primarily works by enhancing vagal tone and is more effective for rate control rather than rhythm maintenance in atrial fibrillation. Diltiazem is a calcium channel blocker best suited for rate control rather than rhythm maintenance. Sotalol, another class III antiarrhythmic, can be