<b>Atrial Fibrillation and Flutter</b>: Maintaining Stability of Sinus Rhythm Versus Ventricular Rate Control

Antman, Elliott M.

doi:10.1111/j.1540-8167.1995.tb00372.x

Cited by 16 publications

(2 citation statements)

References 60 publications

(2 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The goal of rhythm conversion is considered to be more successful when no underlying myocardial disease can be documented or early intervention prior to myocardial failure is instituted. 9 The therapeutic strategy of decreasing the rate of ventricular depolarization allows more time for ventricular filling and decrease myocardial oxygen consumption.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of hypothermia‐induced atrial fibrillation in a dog

Campbell¹,

Day²

2004

J Vet Emergen Crit Care

View full text Add to dashboard Cite

Objective: To report a case of spontaneous resolution of atrial fibrillation secondary to hypothermia in a dog without detectable heart disease. Case summary: An 8‐year‐old female spayed mixed breed dog presented with a history of prolonged exposure to below freezing environmental temperatures. The dog presented hypothermic (<32°C or <90°F) and minimally responsive to stimuli. The heart rate was 80 beats per minute (bpm) and irregular. Atrial fibrillation was diagnosed. The dog had pale mucous membranes, absent femoral pulses, and no obtainable blood pressure via indirect Doppler technique. Resuscitation fluids were administered and active external warming was instituted. Peripheral edema was observed during the rewarming phase and the irregular heart rate was noted to increase. The atrial fibrillation spontaneously resolved with no specific anti‐arrhythmic therapy. No underlying myocardial disease was found. The recovery of this dog was complete with a subsequent repeat of the echocardiogram and electrocardiogram (ECG) 8‐months later found to be within normal limits.

show abstract

Section: Discussionmentioning

confidence: 99%

Spontaneous resolution of hypothermia‐induced atrial fibrillation in a dog

Campbell¹,

Day²

2004

J Vet Emergen Crit Care

View full text Add to dashboard Cite

show abstract

“…If these goals are met, improvement in the quality of life should follow. However, such goals must be attained without an increase in mortality or intolerable morbidity.With an appropriate choice of atrioventricular (AV) nodal blocking drugs (digoxin, beta-blockers, or certain calcium channel blockers) slowing of the ventricular response to ameliorate symptoms such as palpitations, presyncope, and fatigue may be achieved in most patients (14). Control of ventricular response may also avert the development of congestive heart failure in patients with diminished ventricular function.…”

mentioning

confidence: 99%

Review : Restoring Sinus Rhythm in Patients with Atrial Flutter and Fibrillation: Pharmacologic or Electrical Cardioversion?

Gallik

Altamirano

Singh

1997

J Cardiovasc Pharmacol Ther

View full text Add to dashboard Cite

Atrial fibrillation and atrial flutter, the most frequently encountered tachyarrhythmias requiring treatment, have become a major focus for clinical and basic research in recent years. Restoration and maintenance of sinus rhythmn, having been shown to improve exercise capacity, alleviate symptoms, and reduce the incidence of thromboembolic events, may be the optimal management strategy. Identification of the safest, most efficacious and cost-effective means of restoring sinus rhythm is necessary prior to the institution of optimal antiarrhythmic therapy to maintain sinus rhythm. Potential advantages of pharmacologic compared with electrical cardioversion include lack of need for general anesthesia and likely lower cost. Pharmacologic conversion include lack of need for general anesthesia and likely lower cost. Pharmacologic conversion has been accomplished with drugs that prolong atrial refractorinerss, including class Ia (quinidine, procainamide, disopyramide), class Ic (flecainide, propafenone), and class II (sotalol, amiodarone) compounds. The so-called pure class III agents were created to overcome the blocker side effects of sotalol and the complex pharmacodynamic profile of amiodarone. Two such agents are dofetilide, which selectively blocks the rapid component of the delayed rectifier current (Ikr) and ibutilide, which augments the slow inward sodium current, with a smaller component of action mediated by the block of Ikr. Reported overall conversion rates for recent onset atrial fibrillation and atrial flutter were 31% and 54% for difetilide, respectively, and 29-31% and 38-63%, respectively, for ibutilide. Proarrhythmia, manifested as polymorphic ventricular tachycardia requiring cardioversion, was a significant early side effect of both agents. Data from clinical trtials with these new agents, combined with increasing nowledge of the electrophysiologic substrate for these arrhythmias, has renewed initerest in the development of safer, more efficacious class IIIdrugs for atrial fibrillation and atrial flutter conversion.

show abstract

Atrial fibrillation: A review of mechanism, etiology, and therapy

Mackstaller

Alpert

1997

Clinical Cardiology

View full text Add to dashboard Cite

Summary:The prevalence of elderly individuals in the populations of developed countries is increasing rapidly, and atrial tibrillation (AF) is quite common in these elderly patients: currently, 11 % of the U.S. population is between the ages of 65 and 85 years; 70% of people with AF are between the ages of 65 and 8.5 years. AF causes symptoms secondary to hemodynamic derangements that are the result of increased ventricular response and loss of atrial booster function. AF can lead to reversible impairment of left ventricular function, cardiac chamber dilatation, clinical heart failure, and thromboembolic events. AF requires treatment in order to prevent these potential complications. Type la, Ic, and 111 antiarrhythmics are capable of converting AF to normal sinus rhythm (NSR). Amiodarone has the greatest efficacy and safety for converting AF and maintaining NSR while digoxin and verapamil are ineffective in restoring NSR. Quinidine, flecainide, disopyramide, and sotalol have also been shown to maintain NSR after conversion of AE Proarrhythmia is a definite concern with the latter four agents. Alternative therapy for AFindudes anticoagulation with warfarin or aspirin for the prevention of thromboembolic events, and a variety of agents to control the ventricularresponse. All medications used to treat AF carry significant risks in the elderly, whether from proarrhythmia, overdosing because of compliance errors, or hemorrhage secondary to anticoagulation. Treatment of AF must be based on a careful risk-benefit evaluation. The physician must know the capability of the particular patient as well as

show abstract

Atrial Fibrillation and Flutter: Maintaining Stability of Sinus Rhythm Versus Ventricular Rate Control

Cited by 16 publications

References 60 publications

Spontaneous resolution of hypothermia‐induced atrial fibrillation in a dog

Spontaneous resolution of hypothermia‐induced atrial fibrillation in a dog

Review : Restoring Sinus Rhythm in Patients with Atrial Flutter and Fibrillation: Pharmacologic or Electrical Cardioversion?

Atrial fibrillation: A review of mechanism, etiology, and therapy

Contact Info

Product

Resources

About