scholarly journals Rate control strategies for atrial fibrillation

2021 ◽  
Vol 53 (1) ◽  
pp. 682-692
Author(s):  
Muath Alobaida ◽  
Abdullah Alrumayh
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Control Strategies

scholarly journals Comparison of Rhythm and Rate Control Strategies for Stroke Occurrence in a Prospective Cohort of Atrial Fibrillation Patients

2018 ◽  
Vol 59 (2) ◽  
pp. 258 ◽  
Author(s):  
Yu Jeong Choi ◽  
Ki-Woon Kang ◽  
Tae-Hoon Kim ◽  
Myung-Jin Cha ◽  
Jung-Myung Lee ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Prospective Cohort ◽  
Control Strategies

scholarly journals An International Observational Prospective Survey Assessing the Control of Atrial Fibrillation in Asia-Pacific: Results of the Record-AFAP Registry

2015 ◽  
Vol 9 ◽  
pp. CMC.S22022 ◽  
Author(s):  
John Amerena ◽  
Shih-Ann Chen ◽  
Charn Sriratanasathavorn ◽  
Jeong-Gwan Cho ◽  
Huang Dejia ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Treatment Strategy ◽  
Control Strategies ◽  
Asia Pacific ◽  
Therapeutic Success ◽  
Cardiovascular Comorbidities ◽  
Choice Of Treatment ◽  
History Of ◽  
And Control

A prospective 1-year observational survey was designed to assess the management and control of atrial fibrillation (AF) in eight countries within the Asia-Pacific region. Patients ( N = 2,604) with recently diagnosed AF or a history of AF ≤1 year were included. Clinicians chose the treatment strategy (rhythm or rate control) according to their standard practice and medical discretion. The primary endpoint was therapeutic success. At baseline, rhythm- and rate-control strategies were applied to 35.7% and 64.3% of patients, respectively. At 12 months, therapeutic success was 43.2% overall. Being assigned to rhythm-control strategy at baseline was associated with a higher therapeutic success (46.5% vs 41.4%; P = 0.0214) and a lower incidence of clinical outcomes (10.4% vs 17.1% P < 0.0001). Patients assigned to rate-control strategies at baseline had higher cardiovascular morbidities (history of heart failure or valvular heart disease). Cardiovascular outcomes may be less dependent on the choice of treatment strategy than cardiovascular comorbidities.

Rhythm control better prevents stroke and mortality than rate control strategies in patients with atrial fibrillation - A nationwide cohort study

2018 ◽  
Vol 270 ◽  
pp. 154-159 ◽  
Author(s):  
Chi-Jen Weng ◽  
Cheng-Hung Li ◽  
Ying-Chieh Liao ◽  
Che-Chen Lin ◽  
Jiunn-Cherng Lin ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Cohort Study ◽  
Rate Control ◽  
Control Strategies ◽  
Rhythm Control

scholarly journals Management strategies for atrial fibrillation and flutter in patients with transthyretin cardiac amyloidosis

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Z Dale ◽  
P Chandrashekar ◽  
L Al-Rashdan ◽  
M Kim ◽  
A Masri ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Cardiac Amyloidosis ◽  
Control Strategies ◽  
Nyha Class ◽  
Management Strategies ◽  
Symptomatic Improvement ◽  
Rhythm Control ◽  
Ventricular Rate ◽  
Ventricular Response

Abstract Background Atrial fibrillation (AF) and flutter (AFL) are common in transthyretin cardiac amyloidosis (ATTR-CM). Ventricular rate control drugs in ATTR-CM are poorly tolerated but data addressing tolerability and efficacy of rhythm control strategies is limited. Purpose We report characteristics and outcomes of AF/AFL in a cohort with ATTR-CM. Methods A single center observational study of patients seen at our Amyloidosis Center with wild-type or hereditary ATTR-CM diagnosed between 2005–2019. Treatment was prescribed as per treating cardiologists. Results Eighty-four patients with ATTR-CM (average age 74±10 years, 94% male) had mean follow-up of 27.6±22.8 months. AF/AFL occurred in 61 patients (73%). Clinically significant rapid ventricular response (RVR) was common as well attempted rate control with AV node blockers (Table 1). However, discontinuation was frequent (80%), often for adverse effects of hypotension (33%), bradycardia (15%), or presyncope/syncope (10%). Rhythm control was initiated in 64%, most often with cardioversion (DCCV) or ablation (Table 2). Post-DCCV recurrence was common (91%) and time to recurrence did not differ with use of anti-arrhythmic drugs (AAD; 5.8 months (IQR 1.9–12.5) vs without AAD 6.2 months (IQR 1.9–12.5) p=0.83). TEE was performed for 33% of DCCV with thrombus seen in 11% of cases – all patients who were not anticoagulated at the time. TEE was otherwise deferred due to known AF/AFL duration &lt;48 hours (13%) or adequate anticoagulation (54%). Ablation was performed in 23% of patients with AFL (all for typical AFL) with 2 patients (14%) having recurrence after mean of 60.9 months. Pulmonary vein isolation for AF was performed in 12% (86% for persistent AF) with 86% recurrence after median of 6.2 months (IQR 5.6–12.3). Most patients (62%) with rhythm control had subjective improvement (≥1 NYHA class or resolved palpitations). Among AAD, amiodarone was most well tolerated with only 8% of patient discontinuing due to side effects. DCCV and ablation resulted in no direct complications although one patient had a perforation of a previously unknown Zenker diverticulum during TEE pre-DCCV. Conclusions In our ATTR-CM cohort, AF/AFL was common. Rate control was poorly tolerated and often abandoned. While rhythm control of AF/AFL had a favorable safety profile and successful conversion to sinus rhythm led to symptomatic improvement in a majority of cases, durable success with rhythm control was limited, often requiring multiple therapies. DCCV is only modestly successful and not significant improved with AAD. Ablation was successful in cases of cavo-tricuspid isthmus dependent AFL but had limited success in AF. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Rhythm versus rate control strategies regarding anticoagulant use in elderly non-valvular atrial fibrillation patients: Subanalysis of the ANAFIE (All Nippon AF In the Elderly) Registry

2020 ◽  
Vol 76 (1) ◽  
pp. 87-93
Author(s):  
Hitomi Yuzawa ◽  
Hiroshi Inoue ◽  
Takeshi Yamashita ◽  
Masaharu Akao ◽  
Hirotsugu Atarashi ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Control Strategies ◽  
The Elderly

Atrial Fibrillation

2011 ◽  
Author(s):  
Gregory F. Michaud ◽  
Roy M. John
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Oral Anticoagulation ◽  
Thrombus Formation ◽  
Control Strategies ◽  
Anticoagulation Therapy ◽  
Scoring Systems ◽  
Right Atrial ◽  
Medical Attention ◽  
Clinical Consequences

Atrial fibrillation (AF) is an abnormal rhythm characterized by chaotic atrial electrical activity resulting in loss of atrial contraction, an irregular and unpredictable heart rate, and a tendency for thrombus formation. The prevalence of AF is estimated at 1 to 2%, but it’s likely higher than that because one-third of patients may have no symptoms and might never seek medical attention. Data suggest that 1 in 4 people over the age of 40 will develop AF in their lifetime. About 10% of patients over age 80 have experienced the arrhythmia, and some estimates predict the prevalence will double in the next 50 years. This chapter discusses the pathophysiology, genetics, diagnosis, classification, and treatment of AF. Figures show atrial fibrillation and coarse atrial fibrillation plus common right atrial flutter. One algorithm is for oral anticoagulation therapy, and a second shows a recommended hierarchical choice of antiarrhythmic therapies versus catheter ablation for recurrent symptomatic atrial fibrillation. Tables list classification, diagnostic evaluation of, clinical consequences of, and conditions often associated with atrial fibrillation. Three scoring systems are included: 1) for congestive heart failure, hypertension, diabetes, stroke, and transient ischemic attack; 2) to assess the risk of bleeding with oral anticoagulation, and 3) data and proportion of patients from the Euro Heart Survey. Other tables include long-term anticoagulation guidelines for atrial fibrillation, intravenous drugs used for acute rate control, oral drugs used for chronic rate control, and antiarrhythmic drugs for conversion of atrial fibrillation and/or maintenance of sinus rhythm. In addition, there’s a summary of randomized trials weighing rate control and rhythm control strategies, plus schemes for categorizing thromboembolism risk. This review contains 4 highly rendered figures, 13 tables, and 129 references.

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