Russian Heart Failure Journal 2004year Atrial fibrillation: heart rate control or heart rhythm control


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2004/

Atrial fibrillation: heart rate control or heart rhythm control

Tatarsky B.A.

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Atrial fibrillation (AF) is the most common arrhythmia in clinical practice. The AF prevalence increases with age and in the presence of heart organic pathology. AF is an independent predictor of death and the yearly risk for AF-associated stroke is 3–7%. In the recent decade efforts of cardiologists have been focused on the major dilemma of therapy for AF with respect to the choice of optimum strategy: either heart rate control (in the conditions of persistent AF) or restoration and as long as possible maintenance of sinus rhythm. Analysis of recent studies has shown that extremes should be avoided and the heart rate control should not be regarded as a priority approach in all patients with AF. It should be kept in mind that AF is associated with side effects and risks, which should be considered against the risk and side effects of therapy used for AF treatment. Population of patients with AF is not a homogenous population, in which a unified therapeutic approach could be used. In addition, heterogeneity of AF mechanisms determines different (therapeutic and surgical) strategies of therapy in such patients.

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