scholarly journals Benefits of Rhythm Control and Rate Control in Recent‐onset Atrial Fibrillation: The HERMES ‐ AF Study

2019 ◽  
Vol 26 (9) ◽  
pp. 1034-1043 ◽  
Author(s):  
Alfonso Martín ◽  
Blanca Coll‐Vinent ◽  
Coral Suero ◽  
Amparo Fernández‐Simón ◽  
Juan Sánchez ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Rate Control ◽  
Rhythm Control ◽  
Recent Onset ◽  
Onset Atrial Fibrillation

scholarly journals Use of rate control medication before cardioversion of recent-onset atrial fibrillation or flutter in the emergency department is associated with reduced success rates

CJEM ◽  
2012 ◽  
Vol 14 (03) ◽  
pp. 169-177 ◽  
Author(s):  
Gabriel E. Blecher ◽  
Ian G. Stiell ◽  
Brian H. Rowe ◽  
Eddy Lang ◽  
Robert J. Brison ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Emergency Department ◽  
Rate Control ◽  
Rhythm Control ◽  
Electrical Cardioversion ◽  
Ventricular Rate ◽  
Recent Onset ◽  
Factors Associated ◽  
Onset Atrial Fibrillation ◽  
Control Medication

ABSTRACTObjective:It is believed that when patients present to the emergency department (ED) with recent-onset atrial fibrillation or flutter (RAFF), controlling the ventricular rate before cardioversion improves the success rate. We evaluated the influence of rate control medication and other variables on the success of cardioversion.Methods:This secondary analysis of a medical records review comprised 1,068 patients with RAFF who presented to eight Canadian EDs over 12 months. Univariate analysis was performed to find associations between predictors of conversion to sinus rhythm including use of rate control, rhythm control, and other variables. Predictive variables were incorporated into the multivariate model to calculate adjusted odds ratios (ORs) associated with successful cardioversion.Results:A total of 634 patients underwent attempted cardioversion: 428 electrical, 354 chemical, and 148 both. Adjusted ORs for factors associated with successful electrical cardioversion were use of rate control medication, 0.39 (95% confidence interval [CI] 0.21-0.74); rhythm control medication, 0.28 (95% CI 0.15-0.53); and CHADS2score > 0, 0.43 (95% CI 0.15-0.83). ORs for factors associated with successful chemical cardioversion were use of rate control medication, 1.29 (95% CI 0.82-2.03); female sex, 2.37 (95% CI 1.50-3.72); and use of procainamide, 2.32 (95% CI 1.43-3.74).Conclusion:We demonstrated reduced successful electrical cardioversion of RAFF when patients were pretreated with either rate or rhythm control medication. Although rate control medication was not associated with increased success of chemical cardioversion, use of procainamide was. Slowing the ventricular rate prior to cardioversion should be avoided.

Performance of an expedited rhythm control method for recent onset atrial fibrillation in a community hospital

2015 ◽  
Vol 33 (7) ◽  
pp. 957-962 ◽  
Author(s):  
Jennifer L. White ◽  
Michael B. Heller ◽  
Robert J. Kahoud ◽  
Daniel Slade ◽  
John D. Harding
Keyword(s):  
Atrial Fibrillation ◽  
Community Hospital ◽  
Control Method ◽  
Rhythm Control ◽  
Recent Onset ◽  
Onset Atrial Fibrillation

scholarly journals Vernakalant in Atrial Fibrillation: A Relatively New Weapon in the Armamentarium Against an Old Enemy

2019 ◽  
Vol 13 ◽  
pp. 117739281986111 ◽  
Author(s):  
Antoine Kossaify
Keyword(s):  
Atrial Fibrillation ◽  
Heart Disease ◽  
Structural Heart Disease ◽  
Rhythm Control ◽  
Disease Class ◽  
Recent Onset ◽  
Comprehensive Management ◽  
Class Iib ◽  
Pharmacological Cardioversion ◽  
Onset Atrial Fibrillation

Atrial fibrillation is the most common sustained cardiac arrhythmia, and its prevalence is increasing with age; also it is associated with significant morbidity and mortality. Rhythm control is advised in recent-onset atrial fibrillation, and in highly symptomatic patients, also in young and active individuals. Moreover, rhythm control is associated with lower incidence of progression to permanent atrial fibrillation. Vernakalant is a relatively new anti-arrhythmic drug that showed efficacy and safety in recent-onset atrial fibrillation. Vernakalant is indicated in atrial fibrillation (⩽7 days) in patients with no heart disease (class I, level A) or in patients with mild or moderate structural heart disease (class IIb, level B). Moreover, Vernakalant may be considered for recent-onset atrial fibrillation (⩽3 days) post cardiac surgery (class IIb, level B). Although it is mainly indicated in patients with recent-onset atrial fibrillation and with no structural heart disease, it can be given in moderate stable cardiac disease as alternative to Amiodarone. Similarly to electrical cardioversion, pharmacological cardioversion requires a minimal evaluation and cardioversion should be included in a comprehensive management strategy for better outcome.

699 Late increase of inflammatory markers in patients with recent onset atrial fibrillation is related with cardioversion outcome

2007 ◽  
Vol 6 (1) ◽  
pp. 154-154
Author(s):  
A KALOGEROPOULOS ◽  
A RIGOPOULOS ◽  
S PAPATHANASIOU ◽  
S TSIODRAS ◽  
S DRAGOMANOVITS ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Inflammatory Markers ◽  
Recent Onset ◽  
Onset Atrial Fibrillation

Optimizing Heart Rate and Controlling Symptoms in Atrial Fibrillation

2016 ◽  
Vol 10 (1) ◽  
pp. 26
Author(s):  
Pragnesh Parikh ◽  
◽  
KL Venkatachalam ◽  
Keyword(s):  
Risk Factors ◽  
Atrial Fibrillation ◽  
Rate Control ◽  
Stroke Risk ◽  
Symptom Control ◽  
Review Article ◽  
Rhythm Control ◽  
Ventricular Rate ◽  
Control Methods ◽  
Novel Approaches

Atrial fibrillation (AF) is the most common arrhythmia noted in clinical practice and its incidence and prevalence are on the rise. The single most important intervention is the evaluation and treatment of stroke risk. Once the risk for stroke has been minimized, controlling the ventricular rate and treating symptoms become relevant. In this review article, we emphasize the importance of confirming and treating the appropriate arrhythmia and correlating symptoms with rhythm changes. Furthermore, we evaluate some of the risk factors for AF that independently result in symptoms, underlining the need to treat these risk factors as part of symptom control. We then discuss existing and novel approaches to rate control in AF and briefly cover rhythm control methods.

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