2006, Number S2
PDF size: 76.10 Kb.
ABSTRACTThe atrial fibrillation treatment has been controversial since almost a century. Several studies have been done and there is not a clear therapeutic strategy despite the new technological advances. The disyuntive persist between sinus rhythm control vs ventricular rate control. The main studies like AFFIRM, RACE, PIAF, PAF2 and STAF have not shown a definitive strategy treatment. Recently, several subgroups have been stablished and variables like life quality and functional state have been included. New therapeutic strategies have resulted. Heart rate control is recommendable for asymptomatic 65 years old patients and older, whereas rhythm control is better for patients with severe symptoms.
MC NAMARA R, TAMARIZ L, SEGAL J, BASS E: Management of atrial fibrillation: Review of the evidence for the role of pharmacologic therapy, electrical cardioversion, and echocardiography. Ann Intern Med 2003; 139: 1018-1033.
VIDAILLET H, GREENLEE R: Rate control versus rhythm control. Curr Opin Cardiol 2005; 20: 15-20.
CRIJNS HJ: Rate versus rhythm control in patients with atrial fibrillation: What the trials really say. Drugs 2005; 65(12): 1651-67.
BLOOM HL: Concise review of atrial fibrillation: Treatment update considerations in light of AFFIRM and RACE. Clin Cardiol 2004; 27(9): 495-500.
CURTIS A, GERSH B, ET AL: Clinical factors that influence response to treatment strategies in atrial fibrillation: The atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study. Am Heart J 2005; 149: 645-9.
HAGENS V, CRIJNS H, VAN VELDHUISEN D, VAN DEN BERG M, ET AL: Rate control versus rhythm control for patients with persistent atrial fibrillation with mild to moderate heart failure: Results from the rate control versus electrical cardioversion (RACE) study. Am Heart J 2005; 149: 1106-11.
SINGH BN, SINGH S REDA DJ, ET AL: Amiodarone versus sotalol for atrial fibrillation. N Engl J Med 2005; 352: 1361-72.
CHUNG M, SHEMANSKI L, SHERMAN D, ET AL: Functional status in rate– versus rhythm-control strategies for atrial fibrillation. JACC 2005; 46(10): 1891-9.