Medical management of atrial fibrillation.
Atrial fibrillation (AF) is the most common sustained tachyarrhythmia encountered in clinical practice. The management of AF remains associated with many challenges that make its treatment a vexing problem. However, in recent years extraordinary progress has been made in the understanding and management of AF. In general, antiarrhythmic drugs for rhythm control have been disappointing. We have a better understanding of pharmacologic cardioversion and this has led to newer strategies, such as intermittent therapy. Several studies have been completed comparing pharmacologic rhythm control with pharmacologic heart rate control. There is also an emerging body of evidence concerning the value of adjunctive drug use for rhythm control using drugs that would not usually be considered to be antiarrhythmic. Finally, antithrombotic therapy is an increasingly important part of the medical management of AF. This article summarizes the results of many of the recent publications and their clinical implications concerning management of this common rhythm disorder.
Hersi
Ahmad
A
The Libin Cardiovascular Institute of Alberta, University of Calgary, Room G009, 3330 Hospital Drive NW,Calgary AB, T2N 4N1, Canada.
Wyse
D George
DG
D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000188:drug therapy / Q000503:physiopathology / Q000517:prevention & control / Q000628:therapy*; D002986:Clinical Trials as Topic; D004554:Electric Countershock; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006329:Heart Conduction System / Q000187:drug effects / Q000503:physiopathology; D006339:Heart Rate / Q000187:drug effects; D006801:Humans
D000889:Anti-Arrhythmia Agents; D005343:Fibrinolytic Agents