Pharmacological Therapy of Atrial Fibrillation and Flutter: Advances and Limitations of Specific Antiarrhythmic Drugs
A problem that has long been debated is whether in patients with atrial fibrillation (AF) we should try to maintain as far as possible the normal sinus rhythm (SR) by utilizing antiarrhythmic drugs and cardioversion in case of relapses, or only to control the heart rate with drugs that slow atrioventricular nodal conduction (digoxin, 13-blockers, calcium channel blockers). The presumed benefits of maintaining SR include the following: better exercise tolerance and a reduction of symptoms, a reduction in the risk of cerebrovascular accidents, improvement of quality of life, and prolonged survival. In fact, however, these possible advantages have never been investigated in large prospective studies. The AFFIRM trial was presented at the last Congress of the American College of Cardiology, but has not been published up to now.
KeywordsAtrial Fibril Antiarrhythmic Drug Structural Heart Disease Atrial Fibril Recurrence Rhythm Control
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