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Titolo:
Maintenance of sinus rhythm as a therapy goal
Autore:
Borggrefe, M; Breithardt, G;
Indirizzi:
Univ Munster, D-48149 Munster, Germany Univ Munster Munster Germany D-48149 v Munster, D-48149 Munster, Germany
Titolo Testata:
EUROPACE
, volume: 1, anno: 2000, supplemento:, C
pagine: C1 - C5
SICI:
1099-5129(200004)1:<C1:MOSRAA>2.0.ZU;2-V
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHRONIC ATRIAL-FIBRILLATION; FOLLOW-UP; RISK; STROKE; FRAMINGHAM; HEALTH; MANAGEMENT; TRIALS;
Keywords:
atrial fibrillation; sinus rhythm; rate control; stroke; arrhythmic death;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
28
Recensione:
Indirizzi per estratti:
Indirizzo: Borggrefe, M Univ Munster, D-48149 Munster, Germany Univ Munster MunsterGermany D-48149 48149 Munster, Germany
Citazione:
M. Borggrefe e G. Breithardt, "Maintenance of sinus rhythm as a therapy goal", EUROPACE, 1, 2000, pp. C1-C5

Abstract

Despite recent advances in our understanding of the mechanisms and consequences of atrial fibrillation, appropriate management of this common condition presents something of a dilemma. Control of ventricular rate alone is a common strategy, considered by many physicians to be the safest treatment option and a relatively simple approach to preserving left ventricular function. Rhythm control using antiarrhythmic agents, however, offers a number of important advantages, with the potential to correct abnormal physiology, increase exercise tolerance, reduce thromboembolic risk, prevent atrial remodelling and eliminate the risk of tachycardia-induced cardiomyopathy. Selection of an appropriate antiarrhythmic agent for such long-term prophylaxisis however problematic. Class I agents are associated with an unacceptableproarrhythmic risk especially in patients with structural heart disease and long-term therapy with the class III agent amiodarone can result in serious non-cardiac adverse effects. It is apparent, therefore, that there is little consensus on appropriate management strategies for atrial fibrillationand less still on the antiarrhythmic agent to be used. A number of studiesare, however, ongoing which attempt to determine the benefits of rhythm versus rate control. These include the PIAF (Pharmacological Intervention in Atrial Fibrillation), AFFIRM (Atrial Fibrillation Follow-up Investigation of Rhythm Management) and RACE (Rate Control versus Electrical Cardio-version) studies, which should provide valuable answers which will help to guide physicians in their therapy choices. (C) 2000 The European Society of Cardiology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/04/20 alle ore 01:55:31