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Rhythm Management in Atrial Fibrillation—with a Primary Emphasis on Pharmacological Therapy: Part 2
Author(s) -
COSTEAS CONSTANTINOS,
KASSOTIS JOHN,
BLITZER MARK,
REIFFEL JAMES A.
Publication year - 1998
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1998.tb00132.x
Subject(s) - medicine , sinus rhythm , atrial fibrillation , rhythm , cardiology , catheter ablation , intensive care medicine
Atrial fibrillation (AF) is the most common, sustained, symptomatic tachyarrhythmia that clinicians are called upon to manage. Management strategies include ventricular rate control coupled with anticoagulation, versus restoration and maintenance of sinus rhythm. Rate control may be achieved pharmacologically, with agents that impair AV nodal conduction directly and/or by increasing parasympathetic/sympathetic balance, or by modifying or ablating the AV nodal region anatomically. Rhythm control may be achieved by electrical or pharmacological conversion followed by maintenance of sinus rhythm by pharmacological (or occasionally ablative) therapies. This article will present current approaches to rate and rhythm control issues in AF. Part 1, published previously, dealt with rate control. Part 2, the current article, details approaches to the restoration of sinus rhythm by electrical and pharmacological means. The former may use transthoracic or catheter‐based energy delivery systems. The latter may use intravenous or oral drug approaches. Part 3, to be published in a subsequent edition of PACE will deal with the maintenance of sinus rhythm.