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Cabins, castles, and constant hearts: rhythm control therapy in patients with atrial fibrillation
S. Willems, C. Meyer, J. de Bono, A. Brandes, L. Eckardt, A. Elvan, I. van Gelder, A. Goette, M. Gulizia, L. Haegeli, H. Heidbuchel, KG. Haeusler, J. Kautzner, L. Mont, GA. Ng, L. Szumowski, S. Themistoclakis, K. Wegscheider, P. Kirchhof,
Jazyk angličtina Země Velká Británie
Typ dokumentu časopisecké články, práce podpořená grantem, přehledy
Grantová podpora
PG/18/33/33780
British Heart Foundation - United Kingdom
FS/13/43/30324
British Heart Foundation - United Kingdom
AA/18/2/34218
British Heart Foundation - United Kingdom
PG/17/30/32961
British Heart Foundation - United Kingdom
NLK
Free Medical Journals
od 1996 do Před 1 rokem
Open Access Digital Library
od 1996-01-01
PubMed
31755940
DOI
10.1093/eurheartj/ehz782
Knihovny.cz E-zdroje
- MeSH
- antiarytmika škodlivé účinky terapeutické užití MeSH
- fibrilace síní farmakoterapie chirurgie terapie MeSH
- katetrizační ablace MeSH
- lidé MeSH
- senioři MeSH
- Check Tag
- lidé MeSH
- senioři MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
Recent innovations have the potential to improve rhythm control therapy in patients with atrial fibrillation (AF). Controlled trials provide new evidence on the effectiveness and safety of rhythm control therapy, particularly in patients with AF and heart failure. This review summarizes evidence supporting the use of rhythm control therapy in patients with AF for different outcomes, discusses implications for indications, and highlights remaining clinical gaps in evidence. Rhythm control therapy improves symptoms and quality of life in patients with symptomatic AF and can be safely delivered in elderly patients with comorbidities (mean age 70 years, 3-7% complications at 1 year). Atrial fibrillation ablation maintains sinus rhythm more effectively than antiarrhythmic drug therapy, but recurrent AF remains common, highlighting the need for better patient selection (precision medicine). Antiarrhythmic drugs remain effective after AF ablation, underpinning the synergistic mechanisms of action of AF ablation and antiarrhythmic drugs. Atrial fibrillation ablation appears to improve left ventricular function in a subset of patients with AF and heart failure. Data on the prognostic effect of rhythm control therapy are heterogeneous without a clear signal for either benefit or harm. Rhythm control therapy has acceptable safety and improves quality of life in patients with symptomatic AF, including in elderly populations with stroke risk factors. There is a clinical need to better stratify patients for rhythm control therapy. Further studies are needed to determine whether rhythm control therapy, and particularly AF ablation, improves left ventricular function and reduces AF-related complications.
Department of Neurology University Hospital Würzburg Würzburg Germany
Garibaldi Nesima Hospital Catania Italy
Hospital Clinic Barcelona Barcelona Spain
Institute for Clinical and Experimental Medicine Prague Czech Republic
Isala Diagram B 5 SMO Zwolle Zwolle Netherlands
National Institute of Cardiology Warsaw Poland
Unit of Electrophysiology and Cardiac Pacing Ospedale Dell'Angelo Venice Italy
University Hospital Antwerp Antwerp Belgium
University of Groningen University Medical Center Groningen Groningen Netherlands
Citace poskytuje Crossref.org
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- $a Willems, Stephan $u AFNET, Münster, Germany. Department of Cardiology, Asklepios Kliniken St Georg, Hamburg, Germany. Semmelweis University, Budapest, Hungary.
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