Long-term Maintenance of Normal Sinus Rhythm in Patients With Current Symptomatic Atrial Fibrillation

CHEST Journal ◽  
2004 ◽  
Vol 125 (2) ◽  
pp. 377-383 ◽  
Author(s):  
George E. Kochiadakis ◽  
Nikos E. Igoumenidis ◽  
Michail I. Hamilos ◽  
Panos G. Tzerakis ◽  
Nikos C. Klapsinos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Term Maintenance

Sotalol versus propafenone for long-term maintenance of normal sinus rhythm in patients with recurrent symptomatic atrial fibrillation

2004 ◽  
Vol 94 (12) ◽  
pp. 1563-1566 ◽  
Author(s):  
George E. Kochiadakis ◽  
Nikos E. Igoumenidis ◽  
Michail E. Hamilos ◽  
Panagiotis G. Tzerakis ◽  
Nikos C. Klapsinos ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Normal Sinus ◽  
Term Maintenance

Amiodarone for the Maintenance of Sinus Rhythm in Patients with Atrial Fibrillation

1995 ◽  
Vol 29 (6) ◽  
pp. 596-602 ◽  
Author(s):  
Patricia A Howard
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Randomized Trials ◽  
Normal Sinus Rhythm ◽  
Efficacy And Safety ◽  
Long Term Effects ◽  
Normal Sinus ◽  
Review Articles

Objective: To discuss the role of amiodarone for the maintenance of normal sinus rhythm in patients with atrial fibrillation (AF) and review the clinical trial data evaluating the efficacy and safety of amiodarone in patients with AF. Data Sources: A MEDLINE search was used to identify pertinent literature. Additional references were identified from the articles obtained in the search. Key search terms were atrial fibrillation, amiodarone, and sinus rhythm. Study Selection: All studies available at the time the article was prepared evaluating the efficacy and safety of amiodarone in AF were included. In addition, review articles discussing the role of amiodarone in AF were selected. Data Extraction: NO large, prospective, randomized trials have been performed. Data from 8 nonrandomized and 2 randomized trials are reported. Information derived from review articles is discussed. Data Synthesis: In patients with AF, maintenance of normal sinus rhythm is desirable to eliminate symptoms, improve functional capacity, and reduce the risk of thromboembolic complications. Class IA agents traditionally have been used; however, concerns about long-term effects on mortality have focused attention on other agents such as amiodarone. A number of nonrandomized, uncontrolled trials have found amiodarone to be effective for maintaining normal sinus rhythm in patients with AF that is refractory to conventional agents. Two randomized, nonblind trials have found amiodarone's efficacy to be equal to or superior to that of class IA drugs. The findings of these trials must be weighed, however, against the significant potential for toxicity and drug interactions associated with amiodarone. Cardiovascular toxicities, including proarrhythmic effects, appear to be relatively rare. In contrast, noncardiovascular effects are common and potentially serious. Conclusions: Although the preliminary data using amiodarone in AF are encouraging, many questions remain unanswered. Prospective, randomized trials are needed to evaluate the long-term efficacy and safety of amiodarone in patients with AF. Studies also are needed to determine the optimal dosing regimen. Until these data are available, each patient must be evaluated individually, taking into account the relative benefits and risks of therapy. Amiodarone may be particularly useful in patients with significant risks for proarrhythmia and those whose AF is refractory to traditional therapy.

scholarly journals Do all patients with atrial fibrillation need long-term anticoagulation?

2017 ◽  
Vol 7 (3) ◽  
Author(s):  
Munish Sharma ◽  
Rohit Masih ◽  
Daniel A.N. Mascarenhas
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Oral Anticoagulants ◽  
Heart Association ◽  
The United States ◽  
Ventricular Rate ◽  
Normal Sinus ◽  
Systemic Embolization

Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide with an estimated number of 2.7-6.1 million cases in the United States (US) alone. The incidence of AF is expected to increase 2.5 fold over the next 50 years in the US. The management of AF is complex and includes mainly three aspects; restoration of sinus rhythm, control of ventricular rate and prevention of systemic thromboembolism. AF as a cause of systemic embolization has been well known for many years, and majority of patients are on oral anticoagulants (OACs) to prevent this. Many times, a patient may not be in AF chronically, nor is the AF burden (the amount of time patient is in AF out of the total monitored time) calculated. We present three cases of new onset transient AF triggered by temporary stressors. We were able to restore normal sinus rhythm (NSR) with chemical cardioversion. As per 2014 American College of Cardiology (ACC)/American Heart Association (AHA) recommendations, we started all three patients on OACs based on CHA<sub>2</sub>DS<sub>2</sub>VASc score <span style="text-decoration: underline;">&gt;</span>2. However, the patients refused long term OACs after restoration of NSR and correction of the temporary enticing stressors. In any case, the decision to start OACs would have had its own risks. Here we describe how antiarrhythmic drugs were used to maintain NSR, all while they were continuously monitored to determine the need to continue OACs.

Long-Term Efficacy of Amiodarone for the Maintenance of Normal Sinus Rhythm in Patients With Refractory Atrial Fibrillation or Flutter

1995 ◽  
Vol 76 (1-2) ◽  
pp. 47-50 ◽  
Author(s):  
Sung H. Chun ◽  
Philip T. Sager ◽  
William G. Stevenson ◽  
Koonlawee Nademanee ◽  
Holly R. Middlekauff ◽  
...  
Keyword(s):  
Atrial Fibrillation ◽  
Sinus Rhythm ◽  
Normal Sinus Rhythm ◽  
Term Efficacy ◽  
Normal Sinus
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