Open AccessAntiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?
Author(s) -
Reiffel James A.,
Naccarelli Gerald V.
Publication year - 2006
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960290303
Subject(s) - medicine , amiodarone , atrial fibrillation , tolerability , heart rhythm , cardiology , clinical practice , management of atrial fibrillation , clinical trial , drug , intensive care medicine , heart failure , adverse effect , physical therapy , pharmacology
The AFFIRM study showed no clear survival advantage for a rhythm versus rate control strategy in patients with atrial fibrillation (AF). However, rhythm control with antiarrhythmic drugs (AADs) is appropriate in a large number of patients with AF. The American College of Cardiology/American Heart Association/European Society of Cardiology AF management guidelines include a safety‐based algorithm for selection of AAD therapy. Class 1C agents are recommended as first‐line therapy in patients without or with minimal structural heart disease. However, market research and clinical study data indicate a growing use of class III agents (mainly amiodarone) despite long‐term safety and tolerability concerns, suggesting that clinical practice does not adhere to current guidelines.