Clinical review: clinical management of atrial fibrillation - rate control versus rhythm control.
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the critically ill and is associated with adverse outcomes. Although there are plausible benefits from conversion and maintenance of sinus rhythm (the so-called 'rhythm-control' strategy), recent randomized trials have failed to demonstrate the superiority of this approach over the rate-control strategy. Regardless of approach, continuous therapeutic anticoagulation is crucial for stroke prevention. This review addresses the findings of these studies and their implications for clinical management of patients with atrial fibrillation.
Lim
Hoong Sern
HS
University Department of Medicine, City Hospital, Birmingham, UK.
Hamaad
Ali
A
Lip
Gregory Y H
GY
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000628:therapy*; D002986:Clinical Trials as Topic; D003422:Critical Care; D004554:Electric Countershock; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D020521:Stroke / Q000517:prevention & control
D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants