Atrial fibrillation: current therapeutic approaches.
Atrial fibrillation is associated with potentially life-threatening strokes. Anticoagulation with warfarin or aspirin reduces the risk of embolic events in patients with chronic atrial fibrillation and mitral valve stenosis or other underlying heart disease. In patients with acute onset of atrial fibrillation, anticoagulation is not necessary before cardioversion. However, in patients with chronic atrial fibrillation, anticoagulation should be started three weeks before cardioversion and continued for four weeks after the return of normal sinus rhythm. Quinidine remains the agent most commonly used for medical cardioversion in patients who are hemodynamically stable. If a patient is hemodynamically unstable or the atrial fibrillation is not corrected with drug therapy, direct-current electrical cardioversion has a high success rate. Antiarrhythmic (quinidine) therapy is often continued indefinitely to help maintain sinus rhythm.
East Carolina University School of Medicine, Greenville, North Carolina.
H J
HJ
Deantonio
A
A
Movahed
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D002121:Calcium Channel Blockers / Q000008:administration & dosage / Q000627:therapeutic use; D002561:Cerebrovascular Disorders / Q000188:drug therapy / Q000209:etiology / Q000517:prevention & control; D003937:Diagnosis, Differential; D004077:Digoxin / Q000008:administration & dosage / Q000627:therapeutic use; D016903:Drug Monitoring; D004554:Electric Countershock / Q000379:methods / Q000592:standards; D004562:Electrocardiography; D005194:Family Practice / Q000379:methods*; D006801:Humans
D000319:Adrenergic beta-Antagonists; D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants; D002121:Calcium Channel Blockers; D004077:Digoxin