Interní Med. 2007; 9(12): 558-563
Atrial fibrillation management - therapeutic concept in the light of evidence-based medicine
- I. interní klinika FN a LF UP Olomouc
Atrial fibrillation (AF) is the most common clinically important cardiac arrhythmia with increasing prevelance with age. That is why AF is compared to epidemy of moderm age and why AF encourages increasing attention during last decades. Expansion of knowledge targeting etiopathogenesis of AF and therapeutical priorities together with advances in catheter–based ablation technologies extorted need of revision of practice guidelines from 2001. New ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation were published in 2006. Therapeutic strategy in patients with AF involves prevention of thromboembolism, rate control of arrhythmia or rhythm control. Complex therapy of AF combines pharmacological and nonpharmacological treatment modalities. Pharmacological therapeutic options include: anticoagulation or antiagregation, medicaments with negative chronotropic influence on atrioventricular node, antiarrhythmics, drugs modulating the renin-angiotensin-aldosterone system, statins. Nonpharmacological procedures include: direct-current cardioversion, catheter ablation, cardiac pacing, surgical ablation, percutaneous left atrial appendage trasncatheter occlusion. The article describes basic principles of therapeutic strategies, antithrombotic therapy for prevention of thromboembolism, pharmacological rate control during atrial fibrilation, pharmacological cardioversion, pharmacological therapy for maintenance of sinus rhythm as wel as pharmacological modulaton of atrial remodelation.
Keywords: atrial fibrillation, rate control, rhythm control, cardioversion, thromboembolism, guidelines
Published: January 20, 2008 Show citation
