[Atrial fibrillation: always cardioversion? Yes].
It is obvious that sinus rhythm is preferable to atrial fibrillation for the improvement of the clinical conditions of patients and to avoid the risks of anticoagulation. This clinical reality associated with recent scientific evidence, i.e. atrial fibrillation can be treated with focal ablation, a fibrillating atrium undergoes an unfavorable remodeling that can negatively influence attempts of electrical cardioversion, results of clinical studies have demonstrated that a large atrial size and long-standing atrial fibrillation do not represent a contraindication to electrical cardioversion, explain why at present cardiologists try to maintain normal sinus rhythm more than in the past. Results of current studies that compare rate control versus sinus rhythm maintenance could solve the controversy.
Slavich
Gianaugusto
G
Istituto di Cardiologia Azienda Ospedaliera S. Maria della Misericordia Piazzale S. Maria della Misericordia, 15 33100 Udine. slavich@adriacom.it
D001281:Atrial Fibrillation / Q000628:therapy*; D004554:Electric Countershock; D006801:Humans