| Maintenance of sinus rhythm as a therapy goal. | |
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MedLine Citation:
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PMID: 11220518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Despite recent advances in our understanding of the mechanisms and consequences of atrial fibrillation, appropriate management of this common condition presents something of a dilemma. Control of ventricular rate alone is a common strategy, considered by many physicians to be the safest treatment option and a relatively simple approach to preserving left ventricular function. Rhythm control using antiarrhythmic agents, however, offers a number of important advantages, with the potential to correct abnormal physiology, increase exercise tolerance, reduce thromboembolic risk, prevent atrial remodelling and eliminate the risk of tachycardia-induced cardiomyopathy. Selection of an appropriate antiarrhythmic agent for such long-term prophylaxis is however problematic. Class I agents are associated with an unacceptable proarrhythmic risk especially in patients with structural heart disease and long-term therapy with the class III agent amiodarone can result in serious non-cardiac adverse effects. It is apparent, therefore, that there is little consensus on appropriate management strategies for atrial fibrillation and less still on the antiarrhythmic agent to be used. A number of studies are, however, ongoing which attempt to determine the benefits of rhythm versus rate control. These include the PIAF (Pharmacological Intervention in Atrial Fibrillation), AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) and RACE (Rate Control versus Electrical Cardioversion) studies, which should provide valuable answers which will help to guide physicians in their therapy choices. |
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Authors:
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M Borggrefe; G Breithardt |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology Volume: 1 Suppl C ISSN: 1099-5129 ISO Abbreviation: Europace Publication Date: 2000 Jul |
Date Detail:
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Created Date: 2001-02-23 Completed Date: 2001-03-15 Revised Date: 2005-11-16 |
Medline Journal Info:
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Nlm Unique ID: 100883649 Medline TA: Europace Country: England |
Other Details:
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Languages: eng Pagination: C1-5 Citation Subset: IM |
Affiliation:
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Westfälische Wilhelms-University Münster, Germany. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Atrial Fibrillation
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complications,
pathology,
physiopathology*,
therapy* Heart Atria / pathology Heart Conduction System / physiopathology Humans Prognosis |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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