Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation

Bellandi, Francesco; Simonetti, Ignazio; Leoncini, Mario; Frascarelli, Fabio; Giovannini, Tiziana; Maioli, Mauro; Dabizzi, Roberto Piero

doi:10.1016/s0002-9149(01)01806-9

Cited by 77 publications

(29 citation statements)

References 28 publications

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“…The following antiarrhythmic drugs are recommended in patients with AF to maintain sinus rhythm, depending on underlying heart disease and comorbidities (Level of Evidence: A) : Amiodarone (314, 347-349)Dofetilide (332, 336)Dronedarone (350-352)Flecainide (347, 353)Propafenone (347, 354-357)Sotalol (347, 355, 358)…”

Section: Rhythm Controlmentioning

confidence: 99%

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

January¹,

Wann²,

Alpert³

et al. 2014

Circulation

3,578

1,139

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Section: Rhythm Controlmentioning

confidence: 99%

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

January¹,

Wann²,

Alpert³

et al. 2014

Circulation

3,578

1,139

View full text Add to dashboard Cite

“…Although maintenance of sinus rhythm is more likely in patients with shorter AF duration, smaller left atrial size, preserved LV and mitral valve functions, 10 the predictive value of these parameters is poor. For example, data with respect to the impact of left atrial size on the successful maintenance of sinus rhythm are conflicting 11 ; whether this is attributable in part to alterations in atrial compliance merits further investigation.…”

Section: See P 387mentioning

confidence: 99%

Assessing Atrial Mechanical Remodeling and Its Consequences

Hoit

2005

Circulation

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T he principal function of the left atrium is to modulate left ventricular (LV) filling and cardiovascular performance through reservoir, conduit, and booster pump functions; the latter is often (mistakenly) regarded synonymously with atrial function, and in contrast to the reservoir and conduit phases, has been studied extensively. Typically, the importance of atrial contraction has been estimated by measurements of cardiac output and end-diastolic volumes both with and without effective atrial systole, by relative LV filling using Doppler transmitral velocimetry (E/A ratios) or radionuclide angiography, or by atrial shortening using 2D echocardiography, angiography, and sonomicrometry. Despite considerable investigation, the magnitude and relative importance of the atrial contribution to LV filling and cardiac output remain controversial and provide motivation for a more complete evaluation of the atrial cycle. In this regard, nearly half of the LV stroke volume and its associated energy is stored in the left atrium during ventricular systole, which acts as a ventricular restoring force during the ensuing ventricular diastole. 1 This reservoir function of the left atrium is governed by atrial compliance, which is most rigorously measured by mathematically fitting atrial pressure and volume data during ventricular systole. A number of studies have shown, however, that the proportion of left atrial inflow during ventricular systole with Doppler pulmonary venous flow (ie, S/D ratios) can estimate relative reservoir function. Thus, we showed that an isolated change in left atrial compliance alters predictably reservoir function and the pattern of pulmonary venous flow. 2 Decreased atrial compliance is associated with greater phasic atrial pressures but a lower mean level of atrial pressure during ventricular filling, and as a result, a smaller end-diastolic volume and decreased venous return. 3 In contrast, increased atrial compliance increases early LV filling and atrial systolic shortening. 4

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“…However, PV isolation is associated with complications and risks, including PV reconnection, which reduces its efficacy (8)(9)(10). On the other hand, pharmacologic anti-arrhythmic therapy for AF is often ineffective and associated with burdensome side effects (11)(12)(13).…”

Section: Introductionmentioning

confidence: 99%

Melanocyte-like cells in the heart and pulmonary veins contribute to atrial arrhythmia triggers

Levin¹,

Lü²,

Petrenko³

et al. 2009

J. Clin. Invest.

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Atrial fibrillation is the most common clinical cardiac arrhythmia. It is often initiated by ectopic beats arising from the pulmonary veins and atrium, but the source and mechanism of these beats remains unclear. The melanin synthesis enzyme dopachrome tautomerase (DCT) is involved in intracellular calcium and reactive species regulation in melanocytes. Given that dysregulation of intracellular calcium and reactive species has been described in patients with atrial fibrillation, we investigated the role of DCT in this process. Here, we characterize a unique DCT-expressing cell population within murine and human hearts that populated the pulmonary veins, atria, and atrioventricular canal. Expression profiling demonstrated that this population expressed adrenergic and muscarinic receptors and displayed transcriptional profiles distinct from dermal melanocytes. Adult mice lacking DCT displayed normal cardiac development but an increased susceptibility to atrial arrhythmias. Cultured primary cardiac melanocyte-like cells were excitable, and those lacking DCT displayed prolonged repolarization with early afterdepolarizations. Furthermore, mice with mutations in the tyrosine kinase receptor Kit lacked cardiac melanocyte-like cells and did not develop atrial arrhythmias in the absence of DCT. These data suggest that dysfunction of melanocyte-like cells in the atrium and pulmonary veins may contribute to atrial arrhythmias.

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Long-term efficacy and safety of propafenone and sotalol for the maintenance of sinus rhythm after conversion of recurrent symptomatic atrial fibrillation

Cited by 77 publications

References 28 publications

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation

Assessing Atrial Mechanical Remodeling and Its Consequences

Melanocyte-like cells in the heart and pulmonary veins contribute to atrial arrhythmia triggers

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