engleski

Rate control and/or rhythm control in patients with atrial fibrillation

Recently, four prospective trials, PIAF, RACE, AFFIRM and STAF, comparing rate control to rhyhtm control drug strategy in patients with atrial fibrillation (AF) have been published. Both strategies also used anticoagulation therapy with warfarin. A total naumber of included patients was 5034. PIAF, RACE and STAF trials included patients with persistent AF, while AFFIRM trial included patients with persistent (69%) and paroxysmal (31%) AF. The results of these trials have not confirm the superiority of the rhythm control strategy. Thefore, the rate control may be the first line therapy in patients with reccurent persistent AF who have few symptoms, high proarrhythmic risk, or coronary artery disease. The rhythm control remains the first option therapy for AF (paroxysmal or persistent) in younger patients (<60 years), in patients with low proarrhythmic risk, or in patients in whom AF may cause or worse the heart failure. Anticoagulation therapy should be continued in patients who have at least one risk factor for stroke.

atrial fibrillation; rate control; rhythm control

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