Restoration of Sinus Rhythm: Pharmacological or Electrical?
Atrial fibrillation (AF) is the most commonly occurring cardiac arrhythmia; nonetheless, management strategies for its control are far from satisfactory. Most patients experience palpitations, but dyspnea, lightheadedness and fatigue are not uncommon. In some patients even totally asymptomatic AF may be responsible for thromboembolic events, especially in the elderly and in patients with structural cardiac disease. Patients with high ventricular response during AF may develop heart failure and occasionally tachycardia-induced cardiomyopathy. Furthermore, AF has been demonstrated to be associated with decreased survival, regardless of the underlying heart disease . For all these reasons, restoration of sinus rhythm is the ideal therapeutic intervention in the majority of cases; although a general management strategy can be established, a specific risk / benefit balance should be calculated for each individual patient.
KeywordsAtrial Fibrillation Sinus Rhythm Underlying Heart Disease Intravenous Amiodarone Flecainide Acetate
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