Pharmacological Management of Atrial Fibrillation: One, None, One Hundred Thousand

Abstract

atrial fibrillation (AF) is associated with a significant burden of morbidity and increased risk of mortality. Antiarrhythmic drug therapy remains a cornerstone to restore and maintain sinus rhythm for patients with paroxysmal and persistent AF based on current guidelines. However, conventional drugs have limited efficacy, present problematic risks of proarrhythmia and cause significant noncardiac organ toxicity. Thus, inadequacies in current therapies for atrial fibrillation have made new drug development crucial. New antiarrhythmic drugs and new anticoagulant agents have changed the current management of AF. This paper summarizes the available evidence regarding the efficacy of medications used for acute management of AF, rhythm and ventricular rate control, and stroke prevention in patients with atrial fibrillation and focuses on the current pharmacological agents.

Recovery of Visual Function after Administration of Dabigatran Etexilate

“…NAION is known to show spontaneous remission in approximately 40% of the cases [ 4 ], but this assumption notwithstanding, improvement of blood flow is an accepted measure whose indication to preserve or restore vision is undisputed. Therefore, the striking improvement of vision after the administration of dabigatran etexilate in the present case may warrant a systematic clinical trial of a combination of corticosteroids and dabigatran etexilate in comparison with (for instance) warfarin as is common practice under different indications for anticoagulation [ 12 , 13 , 14 ]. However, when ophthalmologists consider the administration of dabigatran etexilate for NAION, certain peculiarities and disadvantages of the drug (such as the lack of an antidote [ 12 , 15 ]) need to be borne in mind to avoid potential hazards.…”

The Challenge of Managing Atrial Fibrillation during Pregnancy

“…Moreover, anti-arrhythmic and anti-coagulation therapies should be used cautiously. Follow-up during pregnancy should be performed by a Pregnancy Heart Team (PHT), or Cardio-Obstetric Team, composed of experienced cardiologists, gynecologists, anesthesiologists, obstetricians and nurses, with at least one visit per trimester [ 127 , 128 , 129 ]. The main aim is to achieve both maternal and fetal safety.…”

Impact of Various Atrial Fibrillation Treatment Strategies on Length of Stay in the Emergency Department and Early Complications—3 Years of a Single-Center Experience

“…Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in the emergency department (ED), constituting a substantial proportion of total ED admissions, ranging from 3.3% to 10% and currently ranking as a primary cause for geriatric visits [ 1 , 2 , 3 ]. Its pervasive prevalence is on the ascent, a consequence attributed to societal lifestyle changes, which, in turn, contribute to an increase in associated diseases and symptoms [ 4 , 5 ].…”

“…* p-value for ANOVA analysis, §, †-p-values for post hoc test. For post hoc tests, only significant values were presented 1. data are presented as median [IQR].…”