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Titolo:
ANTIARRHYTHMIC DRUG-THERAPY TO PREVENT RE CURRENCES OF PAROXYSMAL OR CHRONIC ATRIAL-FIBRILLATION
Autore:
HINDRICKS G; KOTTKAMP H; WILLEMS S; HAVERKAMP W; BORGGREFE M; BREITHARDT G;
Indirizzi:
UNIV KLIN MUNSTER,MED KLIN & POLIKLIN D-48168 MUNSTER GERMANY
Titolo Testata:
Zeitschrift fur Kardiologie
, volume: 83, anno: 1994, supplemento:, 5
pagine: 87 - 96
SICI:
0300-5860(1994)83:<87:ADTPRC>2.0.ZU;2-N
Fonte:
ISI
Lingua:
GER
Soggetto:
SINUS RHYTHM; ELECTRICAL CARDIOVERSION; FLECAINIDE ACETATE; DOUBLE-BLIND; FOLLOW-UP; MAINTENANCE; QUINIDINE; EFFICACY; FLUTTER; AMIODARONE;
Keywords:
ATRIAL FIBRILLATION; ANTIARRHYTHMIC DRUGS; ARRHYTHMIA RECURRENCE;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
39
Recensione:
Indirizzi per estratti:
Citazione:
G. Hindricks et al., "ANTIARRHYTHMIC DRUG-THERAPY TO PREVENT RE CURRENCES OF PAROXYSMAL OR CHRONIC ATRIAL-FIBRILLATION", Zeitschrift fur Kardiologie, 83, 1994, pp. 87-96

Abstract

In many patients with paroxysmal or chronic atrial fibrillation, long-term antiarrhythmic drug therapy is performed to prevent recurrences of atrial fibrillation or to reduce the incidence of paroxysmal attacks of atrial fibrillation. The results of several studies on the efficacy of antiarrhythmic drugs in patients with paroxysmal atrial fibrillation have revealed that the incidence of recurrent attacks of atrial fibrillation can be reduced and the duration of arrhythmia free intervals can be prolonged by antiarrhythmic drug therapy. However, complete prevention of atrial fibrillation can be achieved only in a minority of patients. At present, there is no evidence that antiarrhythmic drug treatment of patients with paroxysmal atrial fibrillation might worsenthe prognosis by an increase in cardiac mortality induced by antiarrhythmic drugs. in patients with chronic atrial fibrillation, the recurrence rate of the arrhythmia can be significantly reduced by antiarrhythmic drug therapy within the first year of treatment. However, there is evidence that antiarrhythmic drugs might worsen the prognosis when compared to patients with atrial fibrillation not treated with antiarrhythmic drugs. Accordingly, the indication for antiarrhythmic drug therapy to prevent recurrences in patients with chronic atrial fibrillation has to be made restrictively and should be largely based on the symptomatic status of the patients. Antiarrhythmic drug therapy seems to be indicated only in patients who are significantly symptomatic or compromised by the arrhythmia. In patients without or with only mild symptoms, medical therapy with the aim to slow the ventricular response with digitalis, calcium antagonists or betablocking agents seems to be more adequate. Currently, with respect to efficacy and safety, there is no antiarrhythmic drug that has been proved to be superior to others and that can thus be recommended as the drug of first choice for patients with paroxysmal or chronic atrial fibrillation to prevent recurrences. The choice of the optimal antiarrhythmic drug should be made by taking individual factors (e.g., etiology of the arrhythmia, patient compliance, liver and renal function of the patient, additional medical therapy) into account. Major problems during long-term antiarrhythmic drug therapy may arise in patients with pre-existing sinus node dysfunction or conduction disturbances of the atrioventricular node. In addition, the conversion of atrial fibrillation with relatively slow ventricular rates to the atrial flutter with fast ventricular rates that is occasionally observed during treatment with class I-antiarrhythmic drugs may complicate longterm therapy. After antiarrhythmic drug therapy has been initiated, the patients require further careful medical control to recognize ineffective drug therapy as well as significant side-effects of antiarrhythmic therapy or potential hazards such as those arising from electrolyte imbalances.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 21/09/20 alle ore 03:28:28