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Updated: May 11, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
[Pharmacological rhythm control strategy for atrial fibrillation]
1Heart Rhythm Center, Tokyo Medical and Dental University.
Summary
Rhythm control therapy, particularly with sodium channel blockers like pilsicainide, benefits atrial fibrillation (AF) patients. For persistent AF or AF with heart disease, amiodarone or bepridil are preferred, with underlying conditions needing treatment first.
Area of Science:
- Cardiology
- Pharmacology
- Electrophysiology
Context:
- Atrial fibrillation (AF) management focuses on rhythm control to enhance patient quality of life.
- Pilsicainide, a pure sodium channel blocker, is a primary therapy for lone paroxysmal AF in Japan.
- Amiodarone and bepridil show defibrillating effects and are considered for persistent AF.
Purpose:
- To outline current recommendations for rhythm control therapy in atrial fibrillation.
- To highlight the role of specific antiarrhythmic drugs based on AF type and cardiac condition.
Summary:
- Sodium channel blockers are first-line for lone paroxysmal AF, with pilsicainide being prevalent in Japan.
- For lone persistent AF, amiodarone and bepridil are preferred rhythm control agents.
- In AF with structural heart disease, amiodarone or bepridil are recommended over sodium channel blockers, emphasizing prerequisite treatment of underlying conditions.
Impact:
- Provides guidance on selecting appropriate antiarrhythmic drugs for diverse atrial fibrillation patient profiles.
- Underscores the importance of tailoring therapy to patient cardiac function and underlying heart disease.
- Contributes to optimizing rhythm control strategies for improved atrial fibrillation management and patient outcomes.
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