Rhythm Control for Management of Patients With Atrial Fibrillation: Balancing the Use of Antiarrhythmic Drugs and Catheter Ablation

被引:9
作者
Viles-Gonzalez, Juan F. [1 ]
Fuster, Valentin
Halperin, Jonathan
Calkins, Hugh [2 ]
Reddy, Vivek Y.
机构
[1] Mt Sinai Hosp, Cardiovasc Inst, Mt Sinai Sch Med, New York, NY 10029 USA
[2] Johns Hopkins Univ Hosp, Sch Med, Johns Hopkins Heart & Vasc Inst, Baltimore, MD 21287 USA
关键词
CONGESTIVE-HEART-FAILURE; PULMONARY-VEIN ABLATION; RADIOFREQUENCY ABLATION; WORLDWIDE SURVEY; DRONEDARONE; EFFICACY; AMIODARONE; THERAPY; PREVENTION; SAFETY;
D O I
10.1002/clc.20857
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Antiarrhythmic drug (MD) therapy may be beneficial for patients with symptoms attributable to atrial fibrillation despite adequate rate control. The limited long-term efficacy of AAD and the relatively large proportion of patients discontinuing therapy because of side effects led to the development of nonpharmacological therapies to achieve rhythm control. Pressing questions remain about the effect of ablation therapy on long-term patient outcomes. Based on recent clinical trials and meta-analyses, ablation appears more effective and possibly safer than MD for long-term maintenance of sinus rhythm in selected patients, but the evidence is insufficient to recommend ablation in preference to drug therapy as the first MD therapy for the majority of patients in whom a rhythm control strategy is justified. Herein, we review the most current evidence supporting the use of AAD and catheter ablation in atrial fibrillation.
引用
收藏
页码:23 / 29
页数:7
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