Monitoring After Cardioversion of Atrial Fibrillation

Lévy, Samuel

doi:10.1002/9780470987483.ch52

Cited by 1 publication

(1 citation statement)

References 19 publications

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“…For these, symptom assessment, periodic electrocardiograms, and/or ambulatory electrocardiographic monitoring are likely to be necessary. Overall, because of the impracticability of monitoring all patients postcardioversion, it is likely that the incidence of recurrence, particularly when patients are asymptomatic, is underestimated 49 . Because of this, it is important that anticoagulation therapy be maintained per guidelines (i.e., for at least 4 weeks postcardioversion or chronically based on risk stratification) 1 …”

Section: The Patient With Persistent Af Who Needs Sinus Rhythmmentioning

confidence: 99%

Cardioversion for Atrial Fibrillation: Treatment Options and Advances

Reiffel

2009

Pacing Clinical Electrophis

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Atrial fibrillation (AF) is associated with significant morbidity and mortality. There are two basic approaches to managing AF: slowing the ventricular rate, while allowing the arrhythmia to continue (the rate-control approach), and restoring and maintaining sinus rhythm (the rhythm-control approach) with antiarrhythmic drugs (AADs) and/or ablation, electrical cardioversion (CV), if needed, or both. Strategy trials comparing rate and rhythm control have found no survival advantage of one approach over the other, but other considerations, such as symptom reduction, often necessitate pursuit of rhythm control. Electrical, or direct current, CV is a widely used and effective method for termination of nonparoxysmal AF, although its success can be affected by patient- and technique-related variables. Pharmacological CV options also exist and are preferable in specific circumstances. Both pharmacological and electrical CV are associated with the risk of proarrhythmia. Many AADs are under development for both CV and maintenance of sinus rhythm. Some are atrioselective, such as vernakalant, and target ion channels in the atria, with little or no effects in the ventricle. Vernakalant, currently under Food and Drug Administration review, appears to offer a safer profile than current CV agents and is likely to expand the role of pharmacological CV. Other new AADs that provide increased efficacy or safety while maintaining normal sinus rhythm may also be better than current drugs; if so, rate-rhythm comparisons will differ from those of previous studies. In conclusion, further trials should clarify the long-term safety profiles of new atrioselective agents and other investigational drugs and define their role in the treatment of AF.

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Section: The Patient With Persistent Af Who Needs Sinus Rhythmmentioning

confidence: 99%

Cardioversion for Atrial Fibrillation: Treatment Options and Advances

Reiffel

2009

Pacing Clinical Electrophis

View full text Add to dashboard Cite

show abstract

Monitoring After Cardioversion of Atrial Fibrillation

Cited by 1 publication

References 19 publications

Cardioversion for Atrial Fibrillation: Treatment Options and Advances

Cardioversion for Atrial Fibrillation: Treatment Options and Advances

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