Treatment for Atrial Fibrillation

Although the symptoms of atrial fibrillation can be nonspecific and may resemble other conditions, some of the key signs are highly specific and should lead to the diagnosis in all patients with AF. Signs that may lead to a diagnosis of AF include a wide-based jugular venous pulse, low-voltage P wave on electrocardiogram (ECG), and a positive drape sign on supine radiographs of the chest and left side of the pelvis.

While AF can occur in anyone, the most important risk factor for incident AF in healthy middle-aged women is early occurrence of ischemic stroke or transient ischemic attack.

Almost one-third had had previous catheter ablation, with catheter ablation being the most common modality. About 1/5 had previously undergone revascularization procedures to treat atrial or ventricular hypertrophy or other heart disorders; of these 9 had undergone PVI as well. While the vast majority of AF patients were treated with anti-arrhythmics, a significant proportion received anticoagulants. The use of PVI for AF in patients with a CHADS2 score of 2 is common, though use of anticoagulants and antiarrhythmic drugs may be greater among those patients with a previous history of atrial fibrillation or heart disease.

The atrial fibrillation is a common heart rhythm disturbance, with an incidence of approximately 1 per 1,000 population and 20% of patients with heart rhythm disturbances. We need to consider more precisely the clinical evaluation of patients with atrial fibrillation and provide optimal therapeutic options.

In our experience, the chances of successful anticoagulation are not higher than other forms of AF; this is especially true if the underlying underlying disease is not related with AF. Results from a recent clinical trial show that anticoagulation alone is a simple and effective strategy in treating patients with persistent AF on drug therapy for primary or secondary AF.

Over two percent of all adults in the US get atrial fibrillation each year. The incidence of atrial fibrillation increases with age and is greatest in those older than 80 years.

The reported side effects of amiodarone can be categorised into acute effects, which appear during the first few days of treatment, and long-term effects, which appear after 1 week of treatment. The common side effects of amiodarone are diarrhoea, fatigue, nausea and vertigo. Rare side effects are serious allergic reactions and severe swelling around the throat.

It has been hypothesized that the treatment of atrial fibrillation is based exclusively on symptomatological effects but recent data indicate that it is possible to alter the heart rhythm permanently. Atrial fibrillation should be considered as a disease with multiple subtypes with different pharmacological and therapeutic treatments possible.

In the majority of cases, AF is idiopathic, that is, there are no known triggers for AF. Idiopathic AF accounts for 75% to 90% of all cases of AF. AF is often associated with left atrial enlargement and hypertrophy.

While HRQoL, as measured by the SF-36, is improved in patients treated with warfarin, in patients treated with oral anticoagulants or aspirin this effect is not statistically significant.

Almost one-third of the patients with atrial fibrillation had no other clinical or laboratory evidence of cardiovascular disease. Almost one-third of them had at least one risk factor associated with a cardiovascular disease. The treatment-eligibility was less favourable for patients with one or more risk factors compared with those who were free of risk. Nevertheless, one-third of all the patients with atrial fibrillation could have been eligible for atrial fibrillation treatment if a treatment had been offered. This should be given special consideration when deciding whether to offer treatment.