[Drug treatment of atrial fibrillation].
Before initiating specific treatment of atrial fibrillation treatable causes must first be reliably ruled out. Furthermore, the chances of maintaining a sinus rhythm must be individually weighed against the potential complications and risks of an anti-arrhythmic therapy, and also alternative strategies considered. Today, rate control is recommended in the case of asymptomatic patients, in particular in the elderly, while rhythm control is the strategy of choice in younger, symptomatic patients. For recurrence prevention, beta blockers are the first-choice drugs. In patients with no structural heart disease, class IC antiarrhythmic agents, in those with structural heart disease only amiodarone, may be considered. Promising new additive therapeutic approaches are ACE-inhibitors and AT-II receptor antagonists. In the future, combinations of pharmacotherapy and non-drug treatments will help to improve the treatment of atrial fibrillation.
Janko
S
S
Städtisches Klinikum, München GmbH, Klinikum Bogenhausen.
Hoffmann
E
E
D000319:Adrenergic beta-Antagonists / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D000638:Amiodarone / Q000008:administration & dosage / Q000627:therapeutic use*; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D000889:Anti-Arrhythmia Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology / Q000601:surgery / Q000628:therapy; D017115:Catheter Ablation; D004359:Drug Therapy, Combination; D004452:Echocardiography; D004554:Electric Countershock; D004562:Electrocardiography; D005424:Flecainide / Q000008:administration & dosage / Q000627:therapeutic use; D006331:Heart Diseases / Q000150:complications; D006339:Heart Rate; D006801:Humans; D008991:Monitoring, Physiologic; D015337:Multicenter Studies as Topic; D011405:Propafenone / Q000008:administration & dosage / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D012008:Recurrence; D012189:Retrospective Studies; D013997:Time Factors
D000319:Adrenergic beta-Antagonists; D000806:Angiotensin-Converting Enzyme Inhibitors; D000889:Anti-Arrhythmia Agents; D011405:Propafenone; D005424:Flecainide; D000638:Amiodarone