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Atrial fibrillation and atrial flutter

D R Geraets1, M G Kienzle

  • 1College of Pharmacy, University of Iowa, Iowa City 52242-1123.

Clinical Pharmacy
|October 1, 1993
PubMed
Summary

Atrial fibrillation (AF) and atrial flutter (AFl) are common arrhythmias. Current treatments focus on rate control, rhythm conversion, and preventing thromboembolism, with ongoing needs for safer therapies.

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Internal Medicine

Background:

  • Atrial fibrillation (AF) and atrial flutter (AFl) are the most common cardiac arrhythmias.
  • Patients often present with palpitations, dyspnea, and reduced exercise tolerance.
  • These arrhythmias increase the risk of hemodynamic compromise and thromboembolism.

Purpose of the Study:

  • To review the epidemiology, pathophysiology, diagnosis, and treatment of AF and AFl.
  • To address recent developments and controversies in managing these arrhythmias.
  • To highlight the need for improved therapeutic strategies.

Main Methods:

  • Review of current literature on AF and AFl.
  • Discussion of pharmacologic and non-pharmacologic treatment modalities.
  • Analysis of therapeutic goals including rate control, rhythm conversion, and thromboembolism prevention.

Main Results:

  • Initial therapy focuses on controlling the ventricular rate using AV node-blocking agents.
  • Pharmacologic rhythm control is effective in approximately 50% of cases but carries risks.
  • Non-pharmacologic options like catheter ablation and surgery are available for refractory cases.
  • Long-term warfarin is recommended for patients remaining in AF despite therapy.

Conclusions:

  • Effective management of AF and AFl requires a multi-faceted approach.
  • There is a significant need for safer and more effective antiarrhythmic drug therapies.
  • Non-pharmacologic interventions are crucial for patients with drug-refractory arrhythmias.

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