Document Detail


Maintenance of sinus rhythm as a therapy goal.
MedLine Citation:
PMID:  11220518     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
M Borggrefe; G Breithardt
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
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:
Created Date:  2001-02-23     Completed Date:  2001-03-15     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  C1-5     Citation Subset:  IM    
Affiliation:
Westfälische Wilhelms-University Münster, Germany.
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MeSH Terms
Descriptor/Qualifier:
Atrial Fibrillation / 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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