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The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
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Management of atrial fibrillation: review of the evidence for the role of pharmacologic therapy, electrical
Robert L McNamara1, Leonardo J Tamariz, Jodi B Segal
1Cardiovascular Section, Yale University School of Medicine, New Haven, Connecticut 06520-8017, USA. robert.mcnamara@yale.edu
Annals of Internal Medicine
|December 18, 2003
Summary
Effective atrial fibrillation management involves rate control, stroke prevention with warfarin or aspirin, and rhythm control using various medications. Echocardiography aids risk assessment and treatment guidance.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Evidence Synthesis
Background:
- Atrial fibrillation (AF) management requires addressing rate control, stroke risk, and rhythm restoration.
- Evidence-based treatment strategies are crucial for optimizing patient outcomes in AF.
Purpose of the Study:
- To review the efficacy of pharmacologic and electrical interventions for atrial fibrillation.
- To assess treatments for ventricular rate control, stroke prevention, acute conversion, and rhythm maintenance.
Main Methods:
- Systematic review of randomized controlled trials from Cochrane Collaboration and MEDLINE.
- Data extraction focused on efficacy and safety, with strength of evidence assessment.
Main Results:
- Rate control strategies showed similar outcomes to rhythm control in most AF patients.
- Warfarin demonstrated strong efficacy for stroke prevention; aspirin showed suggestive efficacy.
- Specific medications like amiodarone and propafenone were effective for rhythm maintenance and acute conversion.
Conclusions:
- Strong evidence supports multiple pharmacologic options for key aspects of atrial fibrillation management.
- Echocardiography is valuable for thromboembolic risk stratification and predicting cardioversion success.
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