Terapia e profilassi della fibrillazione atriale.

Translated title of the contribution: Therapy and prevention of atrial fibrillation

A. Lotto, A. Finzi, R. Manfredini, F. Ambrosini, F. M. Massari

Research output: Contribution to journalArticlepeer-review

Abstract

In the last decade, broader insights into the mechanisms and clinico-prognostic significance of atrial fibrillation have prompted a dramatic shift in the clinician's decision making process in terms of treatment and prevention of this common rhythm disturbance. In fact, evidence of short- or long-term untoward effects on cardiac function and the risk of cerebrovascular accidents, together with a much wider therapeutic armamentarium, form the rationale for the present far more aggressive attitude, aiming at restoring sinus rhythm in all patients in whom an even weak chance exists. The newer class IC (flecainide, propafenone) and class III (amiodarone, sotalol) antiarrhythmic agents are widely and successfully utilized to restore and to maintain sinus rhythm, with significant advantages in comparison with classic quinidine derivatives in terms of efficacy and patient compliance, as demonstrated in clinical controlled trials. Moreover, calcium channels blocking agents as verapamil and diltiazem have been demonstrated more effective than digitalis in the limitation of ventricular rate in patients with chronic atrial fibrillation. Although the advantages of long-term anticoagulation and/or antiaggregation in patients with atrial fibrillation are still being widely investigated at the present time, data obtained in the last years favoured a wider use of this treatment. Many non-pharmacologic interventions have been shown as dramatically effective in particular aspects of atrial fibrillation. Permanent atrial or atrioventricular pacing, alone or in association with antiarrhythmic drugs, has come out as first choice option in patients with bradycardia-tachycardia syndrome. Transcatheter ablation and antiarrhythmic surgical techniques are more and more widely utilized with increasing success in cases refractory to conventional approaches.

Translated title of the contributionTherapy and prevention of atrial fibrillation
Original languageItalian
Pages (from-to)47-54
Number of pages8
JournalCardiologia
Volume36
Issue number8 Suppl
Publication statusPublished - Aug 1991

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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