Pharmacotherapy of atrial fibrillation.
Atrial fibrillation is the most common sustained arrhythmia of clinical significance. Its prevalence rises with age. It is a significant cause of thromboembolic phenomena. We describe briefly the etiology and classification of atrial fibrillation, the risk factors for thromboembolism and stroke associated with it, the indications for hospitalization, and the therapeutic goal. We discuss in depth the management strategies for such patients and compare the impact of rate versus rhythm control in reducing morbidity and mortality attributed to arrhythmia, in light of past and present trials. A brief overview of the drugs used in the management of atrial fibrillation, their pharmacology and dosage, their effects and use in rhythm versus rate control with important side effects are also included. Finally, the prevention and treatment of thromboembolism in patients with atrial fibrillation, an important aspect of therapy, is revisited in light of recent advances.
Kasliwal
Ravi R
RR
Department of Cardiology, Escorts Heart Institute and Research Centre, Okhla Road, New Delhi 110-025, India. rrkasliwal@hotmail.com
Mukesh
Singh
S
Manohar
Gagan
G
Aggarwal
Naveen
N
Bhatia
Atul
A
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000145:classification / Q000188:drug therapy* / Q000209:etiology / Q000628:therapy; D004554:Electric Countershock; D006760:Hospitalization; D006801:Humans; D020521:Stroke / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*; D013923:Thromboembolism / Q000209:etiology / Q000517:prevention & control / Q000628:therapy*
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants