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Updated: Jun 23, 2026
23:33
The WATCHMAN Left Atrial Appendage Closure Device for Atrial Fibrillation
Published on: February 28, 2012
Using the right drug. A treatment algorithm for atrial fibrillation
1Royal Infirmary, Glasgow, U.K.
European Heart Journal
|May 1, 1997
Summary
Atrial fibrillation (AF) management depends on whether it is paroxysmal or sustained. Treatment focuses on suppressing episodes or controlling ventricular rate when cardioversion is not feasible.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Atrial fibrillation (AF) is the most frequent sustained cardiac arrhythmia.
- AF incidence rises with age and is linked to heart disease, thyrotoxicosis, and alcohol.
- AF can manifest as self-terminating paroxysms or sustained arrhythmias.
Purpose of the Study:
- To outline management strategies for paroxysmal and sustained atrial fibrillation.
- To detail therapeutic options for rate control when cardioversion is unsuccessful.
- To present advanced interventions for refractory cases.
Main Methods:
- Review of pharmacological agents for arrhythmia suppression (Class 1C, 2, 3).
- Assessment of cardioversion feasibility and post-procedure management.
- Evaluation of rate-controlling medications (digoxin, beta-blockers, amiodarone, calcium channel blockers).
Main Results:
- Paroxysmal AF management targets episode suppression.
- Sustained AF requires a decision on cardioversion; if unsuccessful, rate control is prioritized.
- Advanced therapies like AV nodal ablation are considered for refractory cases.
Conclusions:
- Therapeutic approaches for atrial fibrillation are stratified based on arrhythmia type and patient factors.
- Rate control is a key strategy for sustained AF, especially when cardioversion fails.
- Atrioventricular nodal modification or ablation offers an alternative for intractable ventricular rate control.
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