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• W2156817042 abstract "Antiarrhythmic drug therapy is the mainstay for managing atrial fibrillation (AF). The main limitations of antiarrhythmic drug therapy include limited effi cacy, potential adverse effects, and the palliative nature of this treatment option. Nevertheless, substantial evidence has emerged suggesting that drugs such as angiotensin-converting enzyme inhibitors and angiotensin receptor-blocking agents can reduce the frequency of AF episodes and may even prevent its development. There have been several trials conducted to assess the effi cacy and risks of several antiarrhythmic agents. Amiodarone has clearly been shown to be the most effective in the majority of these trials; however, it is associated with several cardiac and noncardiac adverse effects. Propafenone is considered to be the best-tolerated drug currently available; however, class 1c agents are associated with increased risk of ventricular fi brillation in patients who have survived a myocardial infarction. Sotalol and dofetilide prolong the QT interval and in some patients can cause torsades de pointes. The effi cacy of pharmacological conversion depends on the duration of AF. Dofetilide, flecainide, ibutilide, and profenone are considered fi rst line and amiodarone second line for pharmacological conversion. In trials, dofetilide and ibutilide appear to have the highest rate of conversion to sinus rhythm. In patients with structural heart disease or prolonged QRS duration, dofetilde and amiodarone are the first choice. In the absence of structural heart disease, ibutilde, flecainide, and propafenone can be used. The “ pill-in-the-pocket” approach suggests that patients with new-onset AF should be treated in the emergency room with an oral class 1c agent. Treatment with both flecainide and propafenone was successful in 94% of episodes, the time to resolution of symptoms was 113 ± 84 min, and 7% of patients reported adverse effects. Newer agents, such as dronaderone and azimilide, are still in the investigational stage." @default.
• W2156817042 created "2016-06-24" @default.
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• W2156817042 date "2008-01-01" @default.
• W2156817042 modified "2023-09-25" @default.
• W2156817042 title "Current Role of Medical Therapy for Prevention or Termination of Atrial Fibrillation" @default.
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• W2156817042 doi "https://doi.org/10.1007/978-1-59745-163-5_13" @default.
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