Rate-control or rhythm-control: where do we stand?

Testa, L; Trotta, G; Dello Russo, A; Casella, M; Pelargonio, G; Andreotti, F and Bellocci, F (2005) Rate-control or rhythm-control: where do we stand? Indian Pacing and Electrophysiology Journal, 5 (4). pp. 296-304. ISSN 0972-6292

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Abstract

Atrial fibrillation is the most common sustained rhythm disturbance and its prevalence is increasing worldwide due to the progressive aging of the population. Current guidelines clearly depict the gold standard management of acute symptomatic atrial fibrillation but the best-long term approach for first or recurrent atrial fibrillation is still debated with regard to quality of life, risk of new hospitalizations, and possible disabling complications, such as thromboembolic stroke, major bleeds and death. Some authors propose that regaining sinus rhythm in all cases, thus re-establishing a physiologic cardiac function not requiring a prolonged antithrombotic therapy, avoids the threat of intracranial or extracranial haemorrhages due to Vitamin K antagonists or aspirin. On the contrary, advocates of a rate control approach with an accurate antithrombotic prophylaxis propose that such a strategy may avoid the risk of cardiovascular and non cardiovascular side effects related to antiarrhythmic drugs. This review aims to explore the state of our knowledge in order to summarize evidences and issues that need to be furthermore clarified

EPrint Type:Article
Uncontrolled Keywords:Atrial fibrillation, Rate control, Rhythm control, Secondary prevention,
Subjects:Physiological Processes > Aging
Population Characteristics > Population
Circulatory and Respiratory Physiology > Cardiovascular Physiology > Cardiovascular Physiologic Phenomena > Hemodynamic Phenomena > Heart Rate
Cardiovascular Agents > Anti-Arrhythmia Agents
Cardiovascular Diseases > Heart Diseases > Arrhythmia > Atrial Fibrillation
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Arrhythmia
ID Code:1096
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:22 October 2005

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