Author:
D. Petrač Department on Arrhythmias and Cardiac Pacing, Bogdan Cardiology Policlinic, Zagreb, Croatia
Vladimira Nozora 44, HR-10000, Zagreb, Croatia

Search for other papers by D. Petrač in
Current site
Google Scholar
PubMed
Close
Restricted access

Abstract

The pharmacological strategy to treat atrial fibrillation (AF) has been studied in the last years by a number of randomized studies. The overall results showed that the rhythm control strategy is not superior to the rate control strategy in terms of mortality or stroke, mostly due to limited efficacy and toxicity of antiarrhyhtmic drugs in the rhythm control patients. Regarding to these data, current antiarrhythmic therapy for recurrent AF is recommended on the basis of choosing safer, although possibly less efficacious drug. Flecainide, propafenone, sotalol and dronedarone are the first-line drugs for patients with a minimal or no heart disease, or hypertension without left ventricular hypertrophy. Sotalol and dronedarone are recommended as first-line drugs for patients with a coronary artery disease. Dronedarone should be considered in order to reduce cardiovascular hospitalizations related to AF/flutter. It can also be used safely in patients with hypertensive heart disease and stable NYHA class I-II heart failure. Amiodarone is the most effective antiarrhythmic in all clinical settings, but because of its toxicity profile should generally be used when other agents have failed or are contraindicated. Amiodarone is recommended as drug of choice in patients with severe heart failure or recently unstable NYHA class II.

  • 1. S. De Denus et al.2005 Rate vs rhythm control in patients with atrial fibrillation: A meta-analysis Arch Intern Med 165 258 262.

  • 2. D. Roy et al.2008 Rhythm control versus rate control for atrial fibrillation and heart failure N Engl J Med 358 2667 2677.

  • 3. S.J. Saxonhouse A.B. Curtis 2003 Risks and benefits of rate control versus maintenance of sinus rhythm Am J Cardiol 91 Suppl 27D 32D.

    • Search Google Scholar
    • Export Citation
  • 4. D. Singh et al.2010 Dronedarone for atrial fibrillation: Have we expanded the antiarrhythmic armamentarium? J Am Coll Cardiol 55 1569 1576.

    • Search Google Scholar
    • Export Citation
  • 5. A.J. Camm et al.2010 Guidelines for the management of atrial fibrillation. The task force for the management of atrial fibrillation of the European Heart Rhythm Association Europace 12 1360 1420.

    • Search Google Scholar
    • Export Citation
  • 6. S.H. Hohnloser et al.2009 Effects of dronedarone on cardiovascular events in atrial fibrillation N Engl J Med 360 668 678.

  • 7. C. Lafuente-Lafuente et al.2006 Antiarrhythmic drugs for maintaining sinus rhythm after cardioversion of atrial fibrillation, A systematic review of randomized trials Arch Intern Med 166 719 728.

    • Search Google Scholar
    • Export Citation
  • 8. J.Y. Le Heuzey et al.2010 A short-term, randomized, double blind, parallel-group study to evaluate the efficacy and safety of dronedarone versus amiodarone in patients with persistent atrial fibrillation: the DIONYSOS Study J Cardiovasc Electrophysiol 21 597 605.

    • Search Google Scholar
    • Export Citation
  • 9. C. Torp-Pedersen et al.2011 Impact of dronedarone on hospitalization burden in patients with atrial fibrillation: results from the ATHENA study Europace 13 1118 1126.

    • Search Google Scholar
    • Export Citation
  • 10. L. Keber et al.2008 Increased mortality after dronedarone therapy for heart failure N Engl J Med 356 2678 2687.

  • 11. S.E. Coplen et al.1990 Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion of atrial fibrillation. A meta-analysis of randomized control trials Circulation 82 1106 1116.

    • Search Google Scholar
    • Export Citation
  • 12. D. Roy et al.2000 for the Canadian Trial of Atrial Fibrillation Investigators N Engl J Med 342 1861 1872.

  • 13. AFFIRM First Antiarrhythmic Drug Substudy Investigators. 2003 Maintenance of sinus rhythm in patients with atrial fibrillation: An AFFIRM substudy of the first antiarrhythmic drug J Am Coll Cardiol 42 20 29.

    • Search Google Scholar
    • Export Citation
  • 14. B.N. Singh et al.2005 Amiodarone versus sotalol for atrial fibrillation: the Sotalol Amiodarone Atrial Fibrillation Efficacy Trial (SAFE-T) N Engl J Med 352 1861 1872.

    • Search Google Scholar
    • Export Citation
  • 15. C. Pappone et al.2006 A randomized trial of circumferential pulmonary vein ablation versus antiarrhythmic drug therapy in paroxysmal atrial fibrillation: The APAF study J AmColl Cardiol 48 2340 2347.

    • Search Google Scholar
    • Export Citation
  • 16. D.J. Wilber et al.2010 Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: A randomized controlled trial JAMA 303 333 340.

    • Search Google Scholar
    • Export Citation
  • 17. Packer DL et al.: Catheter ablation vs antiarrhythmic drug therapy for atrial fibrillation: the results of CABANA pilot study. ACC Atlanta, March 15 (2010).

    • Search Google Scholar
    • Export Citation
  • Collapse
  • Expand

2019  
Scimago
H-index
11
Scimago
Journal Rank
0,220
Scimago
Quartile Score
Medicine (miscellaneous) Q3
Scopus
Cite Score
155/133=1,2
Scopus
Cite Score Rank
General Medicine 199/529 (Q2)
Scopus
SNIP
0,343
Scopus
Cites
206
Scopus
Documents
23

 

Interventional Medicine and Applied Science
Language English
Size  
Year of
Foundation
2009
Publication
Programme
changed title
Volumes
per Year
 
Issues
per Year
 
Founder Akadémiai Kiadó
Founder's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Publisher Akadémiai Kiadó
Publisher's
Address
H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher
Chief Executive Officer, Akadémiai Kiadó
ISSN 2061-1617 (Print)
ISSN 2061-5094 (Online)

Monthly Content Usage

Abstract Views Full Text Views PDF Downloads
Apr 2024 31 0 0
May 2024 4 0 0
Jun 2024 7 0 0
Jul 2024 7 0 0
Aug 2024 27 0 0
Sep 2024 39 0 0
Oct 2024 11 0 0