Short-term versus long-term antiarrhythmic drug treatment after cardioversion of atrial fibrillation (Flec-SL): a prospective, randomised, open-label, blinded endpoint assessment trial

Kirchhof, Paulus; Andresen, Dietrich; Bosch, Ralph F.; Borggrefe, Martin; Meinertz, Thomas; Parade, Ulli; Ravens, Ursula; Samol, Alexander; Steinbeck, Gerhard; Treszl, András; Wegscheider, Karl; Breithardt, Günter

doi:10.1016/s0140-6736(12)60570-4

Cited by 154 publications

(109 citation statements)

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“…Leki antyarytmiczne powodują w przybliżeniu podwojenie częstości utrzymywania rytmu zatokowego w porównaniu z placebo [580][581][582][583][584]. Gdy leki antyarytmiczne zawiodą, często skuteczna jest ablacja przezcewnikowa lub leczenie skojarzone [226,[585][586][587].…”

Section: Leczenie W Celu Kontroli Rytmu Serca U Pacjentów Z Migotanieunclassified

“…Leki antyarytmiczne mogą przywracać rytm zatokowy u pacjentów z AF (kardiowersja farmakologiczna), co wykazano w małych kontrolowanych próbach klinicznych, metaanalizach [41,584,595,596] oraz niewielu większych kontrolowanych próbach klinicznych [597][598][599][600][601][602][603][604][605]. Poza Europą jest dostępny dofetilid, który może przerwać AF o niedawnym początku [606].…”

Section: Leki Antyarytmiczne W Celu Doraźnego Przywracania Rytmu Zatounclassified

“…Wcześniejsze podanie amiodaronu (wymagające kilku tygodni leczenia) [631,632], sotalolu [631], ibutilidu [633] lub wernakalantu [634] może zwiększyć skuteczność kardiowersji elektrycznej, a podobny efekt występuje prawdopodobnie w przypadku podania flekainidu [584] lub propafenonu [635]. Nie ma wiarygodnych danych, które wskazywałyby, że beta-adrenolityki [636], werapamil, diltiazem [637][638][639] oraz digoksyna [640,641] są skuteczne jako leki przerywające AF lub ułatwiające kardiowersję elektryczną.…”

Section: Kardiowersja Elektrycznaunclassified

“…Nie ma wiarygodnych danych, które wskazywałyby, że beta-adrenolityki [636], werapamil, diltiazem [637][638][639] oraz digoksyna [640,641] są skuteczne jako leki przerywające AF lub ułatwiające kardiowersję elektryczną. Jeżeli planuje się farmakoterapię antyarytmiczną w celu utrzymania rytmu zatokowego po kardiowersji, rozsądne wydaje się rozpoczę-cie tego leczenia 1-3 dni przed kardiowersją (w przypadku amiodaronu: kilka tygodni wcześniej) w celu ułatwienia kardiowersji i uzyskania skutecznego stężenia leku we krwi [584,601].…”

Section: Kardiowersja Elektrycznaunclassified

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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

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Section: Leczenie W Celu Kontroli Rytmu Serca U Pacjentów Z Migotanieunclassified

Section: Leki Antyarytmiczne W Celu Doraźnego Przywracania Rytmu Zatounclassified

Section: Kardiowersja Elektrycznaunclassified

See 2 more Smart Citations

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Kirchhof

Benussi

Kotecha³

et al. 2016

Kardiol Pol

Self Cite

2,399

4,206

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“…Delegates at the 4 th AFNET/EHRA consensus conference proposed a classification of AF that reflected the different disease mechanisms. The proposed AF types were: monogenic AF, focally induced AF, postoperative AF, valvular AF, AF in the elderly, polygenic AF, and unclassified AF 45,46 . Unfortunately, however, prospective validation of such a classification is currently lacking, resulting in many patients being classified as 'other' .…”

Section: Guidance Through Af Characterizationmentioning

confidence: 99%

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

et al. 2015

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Despite the important advances that have enabled better stroke prevention in atrial fibrillation (AF) and more effective maintenance of sinus rhythm over the past decades, a large unmet need to improve the prevention and treatment of AF remains. Mortality for AF remains at 3.5% per year, and death is often experienced as sudden death or as a result of heart failure 1,2 . Each year, approximately 20% of patients with AF need to be hospitalized 3,4 , and stroke occurs in 1.5% of patients with AF who are receiving anticoagulant drugs 5 . Furthermore, more than half of the patients with AF are symptomatic despite adequate anticoagulation and rate control 4,6 . In view of the projected increase in the incidence and prevalence of AF 7-9 , as well as the substantial burden of death and dis ability that is still associated with this condition 10 , the status quo is unacceptable.Current management of patients with AF comprises treatment of the accompanying cardiovascular conditions, oral anticoagulation, rate control -with medications that slow atrioventricular nodal recovery or, rarely, with atrioventricular nodal ablation -and rhythm-control therapy with antiarrhythmic drugs, electrical cardioversion, catheter ablation or, at times, AF surgery 11,12 . Unfortunately, most of these current approaches are disconnected from our understanding of the major mechanisms that cause AF 1,13,14 1,2,7,19,20 Abstract | Despite remarkable advances in antiarrhythmic drugs, ablation procedures, and stroke-prevention strategies, atrial fibrillation (AF) remains an important cause of death and disability in middle-aged and elderly individuals. Unstructured management of patients with AF sharply contrasts with our detailed, although incomplete, knowledge of the mechanisms that cause AF and its complications. Altered calcium homeostasis, atrial fibrosis and ageing, ion-channel dysfunction, autonomic imbalance, fat-cell infiltration, and oxidative stress, in addition to a susceptible genetic background, contribute to the promotion, maintenance, and progression of AF. However, clinical management of patients with AF is currently guided by stroke risk parameters, AF pattern, and symptoms. In response to this apparent disconnect between the known pathophysiology of AF and clinical management, we propose a roadmap to develop a set of clinical markers that reflect the major causes of AF in patients. Thereby, the insights into the mechanisms causing AF will be transformed into a format that can underpin future personalized strategies to prevent and treat AF, ultimately informing better patient care.230 | APRIL 2016 | VOLUME 13 www.nature.com/nrcardio CONSENSUS STATEMENT © 2 0 1 6 M a c m i l l a n P u b l i s h e r s L i m i t e d . A l l r i g h t s r e s e r v e d .

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Assessment of Catheter Ablation or Antiarrhythmic Drugs for First-line Therapy of Atrial Fibrillation

et al. 2021

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IMPORTANCEEarly rhythm control of atrial fibrillation (AF) with either antiarrhythmic drugs (AADs) or catheter ablation has been reported to improve cardiovascular outcomes compared with usual care; however, the optimal therapeutic modality to achieve early rhythm control is unclear.OBJECTIVE To assess the safety and efficacy of AF ablation as first-line therapy when compared with AADs in patients with paroxysmal AF.

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Short-term versus long-term antiarrhythmic drug treatment after cardioversion of atrial fibrillation (Flec-SL): a prospective, randomised, open-label, blinded endpoint assessment trial

Cited by 154 publications

References 28 publications

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS

Defining the major health modifiers causing atrial fibrillation: a roadmap to underpin personalized prevention and treatment

Assessment of Catheter Ablation or Antiarrhythmic Drugs for First-line Therapy of Atrial Fibrillation

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