Current issues in atrial fibrillation.

Yaariv Khaykin,Yana Shamiss

doi:10.5402/2012/376071

Yaariv Khaykin, Yana Shamiss

Open Access

https://doi.org/10.5402/2012/376071

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Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. It places an enormous burden on the patients, caregivers, and the society at large. While the main themes in the care of an AF patient have not changed over the years and continue to focus on stroke prevention, control of the ventricular, rate and rhythm maintenance, there have been a number of new developments in each of these realms. This paper will discuss the “hot” topics in AF in 2012 including new and upcoming medical and invasive management strategies for this condition.

Highlights

“There is no other serious cardiac disorder which can be so speedily benefited as the well-managed case of auricular fibrillation. . .the most reliable preparation to use is a fresh and known tincture of digitalis.”
Decisions that need to be made in each Atrial fibrillation (AF) patient care include selection of rhythm control or the more conservative control of the ventricular rate and selection of stroke prevention strategy
In the open-label study of Dabigatran versus Warfarin in Patients with Atrial Fibrillation (RELY) the use of dabigatran, a direct thrombin inhibitor, was associated with similar rates of stroke and systemic embolism but lower rate of major bleeding compared to warfarin at a lower dose of 110 mg, while the higher dose of the drug at 150 mg was associated with 35% lower rates of stroke and systemic embolism but similar rates of major bleeding compared to warfarin [11]

Summary

Introduction

“There is no other serious cardiac disorder which can be so speedily benefited as the well-managed case of auricular fibrillation. . .the most reliable preparation to use is a fresh and known tincture of digitalis.”. . .the most reliable preparation to use is a fresh and known tincture of digitalis.” This quote from Clinical Disorders of the Heart Beat by Lewis published in 1925 [1] could not be further from the truth in 2012. With the multitude of new therapies introduced and in development to address various clinical implications of this most common sustained rhythm disorder, it is becoming a daunting task to select the right approach to each individual patient. Decisions that need to be made in each AF patient care include selection of rhythm control or the more conservative control of the ventricular rate and selection of stroke prevention strategy. Clinical practice guidelines developed by various professional societies attempt to help physicians select the right therapies for the right AF patients. The purpose of this paper is to discuss the “hot” topics in AF care in 2012

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