title: Antiarrhythmic drugs for atrial fibrillation.
abstract: BACKGROUND
  Atrial fibrillation (AF) is associated with increased mortality and morbidity. Although stroke prevention is the only way to improve prognosis, antiarrhythmic drugs (AADs) are of primary importance both in the conversion to sinus rhythm and in the long-term control of rhythm and rate.
  
  
  METHODS
  We searched the Cochrane Library and Medline Database for articles published in English concerning efficacy and safety of AADs in AF. Particular attention was paid to the recently published European Society of Cardiology guidelines. This review provides an overview of the currently available drugs used in AF, with a particular emphasis on their comparative efficacy and safety in different kind of patients. Recent important findings, and advantages and disadvantages of recently approved drugs such as vernakalant and dronedarone, are also discussed.
  
  
  CONCLUSIONS
  AADs remain fundamental in the acute and long-term management of AF, to control symptoms and to reduce the negative impact of the arrhythmia on QoL. The choice of a rate- over rhythm-control strategy should be individualized and based on accurate evaluation of patient medical history and symptoms. New agents will contribute to improve treatment efficacy together with the guarantee of better safety profiles.
authors.affiliation: Clinica di Cardiologia , Università Politecnica delle Marche, Ospedali Riuniti di Ancona, Italy. marinelli.doc@gmail.com
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marinelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Capucci
mesh_terms: D000638:Amiodarone / Q000031:analogs & derivatives / Q000627:therapeutic use; D000840:Anisoles / Q000627:therapeutic use; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use*; D001281:Atrial Fibrillation / Q000150:complications / Q000188:drug therapy* / Q000503:physiopathology; D000077764:Dronedarone; D006339:Heart Rate / Q000187:drug effects / Q000502:physiology; D006801:Humans; D011759:Pyrrolidines / Q000627:therapeutic use; D020521:Stroke / Q000209:etiology / Q000473:pathology* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000840:Anisoles; D000889:Anti-Arrhythmia Agents; D011759:Pyrrolidines; C524581:vernakalant; D000077764:Dronedarone; D000638:Amiodarone