The treatment of atrial fibrillation Atrial fibrilasyon tedavisi: Hiz/ritim
SENDROM, cilt.16, sa.9, ss.33-42, 2004 (Scopus)
- Yayın Türü: Makale / Derleme
- Cilt numarası: 16 Sayı: 9
- Basım Tarihi: 2004
- Dergi Adı: SENDROM
- Derginin Tarandığı İndeksler: Scopus
- Sayfa Sayıları: ss.33-42
- Trakya Üniversitesi Adresli: Hayır
Özet
Atrial fibrillation, which constitutes one third of the hospitalized cases due to rhythm abnormalities, is the most frequently detected arrhythmia type in clinical settings. Atrial fibrillation may cause complications such as systemic embolizations, hemodynamic disturbances, myopathic degeneration due to tachycardia, as well as symptoms decreasing quality of life. Mortality rates in patients with atrial fibrillation are twice as patients with normal sinus rhythm, and atrial fibrillation is accused in two of every six cases of stroke. Therapeutic approaches advocated for atrial fibrillation are; control and maintenance of the rhythm, and rate control and adequate anticoagulation. Presumed advantages of rhythm control and maintenance are; clearance of the symptoms, increased tolerance to exercise, decreased risk of embolization and no further need for chronic anticoagulation, prevention of cardiomyopathy, improvement in quality of life and survival rates. On the other hand, control of the ventricular rate and permitting atrial fibrillation to stabilize are two different strategies which allow the usage of safer medications with fewer adverse effect profiles. However, the latter obligates the need for chronic anticoagulation. There were four large randomized trials comparing rhythm vs. rate control in atrial fibrillation treatment: AFFIRM, RACE, PIAF and STAF. All of these four trials lacked the evidence of priority of rhythm control on the rate control with respect to primary end points.