The findings of this study may serve as a guide in the clinical evaluation of patients with AF and may help to guide the clinician in the choice of anti-arrhythmic therapy.
AF is a type of heart rhythm disorder characterized by rapid heart rates and irregular fibrillations. As a consequence of these irregular beats, the blood pressure in the body begins to fall abruptly, leading to increased chances of heart attack or stroke. The disorder is also correlated with increased odds of atrial fibrillation after an acute myocardial infarction. It is the largest cause of sudden death in people under 60 years of age. As of 2018, approximately 1.5 million people in the United States are diagnosed with the condition and approximately 300,000 to 400,000 people in the United States will die from it per year.
There are many different ways to treat atrial fibrillation. While the best way to treat atrial fibrillation is for every unique person affected by the condition to choose that specific way, there are some ways that any doctor will go about treating atrial fibrillation. One very popular way to prevent atrial fibrillation is by getting vaccinated daily, using medicines such as warfarin and ACE inhibitors to help prevent the development of atrial fibrillation, and quitting the habit of smoking. There are also some different methods of treatment that are in use in the United States, including the use of cardioversion and atrial ablation.
Although an important proportion of subjects with AF can be treated to achieve long-term PVI benefit, the use of this emerging AF treatment strategy is hampered by the persistence of AF in the majority of subjects.
Atrial fibrillation has been linked with the presence of an underlying abnormality, usually valvular or cardiac or even to an underlying mental problem. It also has been argued that there may be some genetic predisposition which can be traced back to the fetal development period of the early human embryonic development. There is some evidence supporting the idea that many of our psychological problems can have an impact on the development of the atria. Atrial fibrillation is thought to be a disease process of the atrylia, or parts of the atria, such as the valves of the heart or sino-atrial node, the muscular parts of the atria, or the surrounding connective tissues.
The incidence of AF in U.S. population is very high and it is expected to increase in a decade at our current rate of change.
In a recent study, findings of the above analyses suggest that the occurrence of atrial fibrillation in the analyzed patients is not connected with hereditary predisposition to the arrhythmia. As a matter of fact familial aggregation seems to be rather weak.
The anti-arrhythmic drug is effective in terminating the arrhythmia (ATPR≥2 in both groups). The higher prevalence of symptomatic re-arrhythmia (ATPR≤1.3) in group D (ATPR=2) might favor use of another anti-arrhythmic drug (for example, amiodarone) when an anti-arrhythmic drug is not working properly.
The side effects usually outweigh the symptomatic benefit of dronedarone. The most common side effect of dronedarone is sinus arrhythmia. When dronedarone is taken with another medication the side effects tend to be lessened to the extent that they usually do not constitute a significant issue. The use of dronedarone with concomitant use of the antimuscarinic medication diphenhydramine may lead to severe and potentially fatal allergic reactions that can occur either during the administration of both or anytime afterwards. The most severe of which result in pulmonary symptoms requiring intubation, hemodynamic instability, and even death. This is a rare but very serious and potentially life-threatening adverse effect.
Dronedarone has a number of unique pharmacologic properties that have proven it to be a viable therapeutic agent for the treatment of patients with refractory AF. It achieves therapeutic levels and is well tolerated in patients. This may prove beneficial during the first few weeks of therapy while we assess the safety profile of dronedarone.
Dronedarone is relatively safe. Although it may cause an isolated event of nausea or vomiting for some patients, the overall risk is low and is outweighed by the benefit of improved arrhythmia outcomes.