Modern principles of antiarrhythmic therapy of atrial fibrillation

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Abstract

Currently, atrial fibrillation (AF) is one of the most common arrhythmias in clinical practice. The prevalence of this heart rhythm disorder in the population exceeds 2%. Despite the fact that AF is not a life-threatening arrhythmia, it leads to an increased risk of thromboembo- lic complications (TEC). According to the latest recommendations for the treatment of AF, the tactics of managing patients should include three directions, which today are commonly called the ABC rule: A) prescribing anticoagulant therapy to patients with an increased risk of TEC; B) treatment of symptoms of arrhythmia, including a strategy to maintain or maintain sinus rhythm); C) treatment of the underlying disease. The most difficult task in the treatment of patients with paroxysmal or persistent forms of AF is considered to be long-term maintenance of the heart rate. This direction in the treatment of AF includes electrical or pharmacological cardioversion followed by long-term antiarrhythmic therapy or radiofrequency catheter ablation. Among the modern antiarrhythmic drugs (AAPs) used for medical cardioversion in AF, the most popular in Russia are amiodarone and propafenone. The choice of AAD is based on an assessment of the severity of the underlying heart disease and the likelihood of side effects with the introduction of a loading dose of the drug. Thus, antiarrhythmic therapy remains one of the important directions in the treatment of patients with AF. Early prescription of AAD and anticoagulant therapy at an increased risk of TEC, catheter ablation can not only improve the quality of life, but also the prognosis of patients with AF.

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About the authors

Aida I. Tarzimanova

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Author for correspondence.
Email: pharmateca@yandex.ru
ORCID iD: 0000-0001-9536-8307

Dr. Sci. (Med.), Associate Professor at the Department of Faculty and Polyclinic Therapy

Russian Federation, Moscow

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