1 / 6

Clinical Overview of Atrial Fibrillation

Clinical Overview of Atrial Fibrillation. Edward L.C. Pritchett, M.D. Consulting Professor of Medicine Divisions of Cardiology and Clinical Pharmacology Duke University Medical Center Durham, North Carolina. Most common sustained cardiac arrhythmia 1

jenn
Download Presentation

Clinical Overview of Atrial Fibrillation

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Clinical Overview of Atrial Fibrillation Edward L.C. Pritchett, M.D. Consulting Professor of MedicineDivisions of Cardiology and Clinical Pharmacology Duke University Medical CenterDurham, North Carolina

  2. Most common sustained cardiac arrhythmia1 Most common diagnosis for arrhythmia-related hospitalization2 Estimated >2.3 million US adults have AF3 Prevalence of AF increases with age and with an aging population4 Atrial Fibrillation Prevalence 1 Bialy D et al. J Am Coll Cardiol 1992; 19-41A. 2 Fuster V et al. Circulation 2006; 114:e257-e354 3 Go AS et al. JAMA 2001; 285:2370-2375. 4 Chug SS et al. J Am Coll Cardiol 2001: 37:371-378

  3. Clinical Presentation of Atrial Fibrillation • Atrial fibrillation is most commonly identified because patients have symptoms1 • The most appropriate use of antiarrhythmic drugs in patients with atrial fibrillation is for relief of symptoms2,3 • Symptoms closely associated with occurrence of atrial fibrillation are palpitations, dyspnea, chest pain, dizziness, asthenia, fatigue, nervousness, increased sweating4 1 Psaty BM et al. Circulation 1997;96:2455-2461. 2 Page RL. N Eng J Med 2004;351:2408-2416 3 Fuster V et al. Circulation 2006;114:e257-e354. 4 Bhandari AK et al. Am Heart J 1992;124:381-386.

  4. Symptomatic Arrhythmias as an Outcome in Antiarrhythmic Drug Approvals for Atrial Fibrillation and Other Supraventricular Arrhythmias • 1986 verapamil PO IR - PSVT • 1991 flecainide PO - PSVT, AF • 1996 ibutilide IV - AF • 1997 propafenone PO IR - PSVT, AF • 1999 dofetilide PO - AF • 2000 d,l sotalol PO - AF • 2003 propafenone SR PO - AF Pritchett E, PACE, 1998;21:1457-1469.

  5. Limitations of Current Therapies Pharmacological Conversion with IV Antiarrhythmic Drugs • Few choices of approved and labeled drugs • Imperfect efficacy • Adverse effects (ventricular arrhythmias) Electrical Cardioversion • Requires conscious sedation • Complications (skin burns, aspiration, bradycardia, ventricular arrhythmia) • Inappropriate in some clinical situations (post-prandial, lung disease, recent cardiac surgery)

  6. Desirable Characteristics of Pharmacologic Converting Agents Efficacy • High rate of restoring sinus rhythm with relief of symptoms • Rapid onset of action Safety • Low rate of adverse effects • Low incidence of drug interactions • Lack of interference with electrical cardioversion

More Related