Finding What You Seek: Analyzing Therapies for Nonvalvular Atrial Fibrillation
Authors: Stephen G. Pauker
Journal: Annals of Internal Medicine (1999)

Editorials20 April 1999Finding What You Seek: Analyzing Therapies for Nonvalvular Atrial FibrillationStephen G. Pauker, MD and Mark H. Eckman, MDStephen G. Pauker, MDTufts-New England Medical Center; Boston, MA 02111-1533 (Pauker)Tufts-New England Medical Center; Boston, MA 02111-1533 (Eckman)Search for more papers by this author and Mark H. Eckman, MDTufts-New England Medical Center; Boston, MA 02111-1533 (Pauker)Tufts-New England Medical Center; Boston, MA 02111-1533 (Eckman)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-130-8-199904200-00017 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Nonvalvular atrial fibrillation is common and can be associated with few hemodynamic symptoms. However, one of its consequences, systemic embolization, produces substantial morbidity and mortality. Over the past decade, the management of patients with nonvalvular atrial fibrillation has been the subject of many clinical trials, numerous conferences, and more papers than any clinician has time to digest. New drugs and therapeutic options abound. Clinicians managing these patients are awash with data and, perhaps, conflicting interpretations of those data. In this issue, Catherwood and colleagues (1) extend a simpler model published 5 years ago (2) to offer a new cost-effectiveness analysis ...References1. Catherwood E, Fitzpatrick WD, Greenberg ML, Holzberger PT, Malenka DJ, Gerling BR, et al . Cost-effectiveness of cardioversion and antiarrhythmic therapy in nonvalvular atrial fibrillation. Ann Intern Med. 1999;130:625-36. LinkGoogle Scholar2. Disch DL, Greenberg ML, Holzberger PT, Malenka DJ, Birkmeyer JD. Managing chronic atrial fibrillation: a Markov decision analysis comparing warfarin, quinidine, and low dose amiodarone. Ann Intern Med. 1994;120:449-57. LinkGoogle Scholar3. Coplen SE, Antman EM, Berlin JA, Hewitt P, Chalmers TC. Efficacy and safety of quinidine therapy for maintenance of sinus rhythm after cardioversion. A meta-analysis of randomized control trials. Circulation. 1990;82:1106-16. CrossrefMedlineGoogle Scholar4. Van Gelder IC, Crijns HJ, Tieleman RG, Brügemann J, De Kam PJ, Gosselink M, et al . Chronic atrial fibrillation. Success of serial cardioversion therapy and safety of oral anticoagulation. Arch Intern Med. 1996;156:2585-92. CrossrefMedlineGoogle Scholar5. Gage BF, Cardinalli AB, Albers GW, Owens DK. Cost-effectiveness of warfarin and aspirin for prophylaxis of stroke in patients with nonvalvular atrial fibrillation. JAMA. 1995;274:1839-45. CrossrefMedlineGoogle Scholar6. Eckman MH, Levine HJ, Salem DN, Pauker SG. Making decisions about antithrombotic therapy in heart disease: decision analytic and cost-effectiveness issues. Chest. 1998;114 5 Suppl 699S-714S. CrossrefMedlineGoogle Scholar7. Eckman MH, Falk RH, Pauker SG. Cost-effectiveness of therapies for patients with nonvalvular atrial fibrillation. Arch Intern Med. 1998;158:1669-77. CrossrefMedlineGoogle Scholar8. Risk factors for stroke and efficacy of antithrombotic therapy in atrial fibrillation. Analysis of pooled data from five randomized, controlled trials. Arch Intern Med. 1994; 154:1449-57. Google Scholar9. Morady F. Radio-frequency ablation as treatment for cardiac arrhythmias. N Engl J Med. 1999;340:534-44. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Tufts-New England Medical Center; Boston, MA 02111-1533 (Pauker)Tufts-New England Medical Center; Boston, MA 02111-1533 (Eckman)Corresponding Author: Stephen G. Pauker, MD, Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111-1533.Current Author Addresses: Drs. Pauker and Eckman: Tufts-New England Medical Center, 750 Washington Street, Boston, MA 02111-1533. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCost-Effectiveness of Cardioversion and Antiarrhythmic Therapy in Nonvalvular Atrial Fibrillation Edward Catherwood , W. David Fitzpatrick , Mark L. Greenberg , Peter T. Holzberger , David J. Malenka , Barbara R. Gerling , and John D. Birkmeyer Metrics Cited ByHow many patients in atrial fibrillation admitted to an acute medical unit will benefit from oral anticoagulation?Cost Effectiveness of Therapies for Atrial Fibrillation 20 April 1999Volume 130, Issue 8Page: 690-691KeywordsAspirinAtrial fibrillationClinical trialsDecision analysisHemodynamicsHemorrhageIschemic strokeMyocardial infarctionStrokeSurvival analysis Issue Published: 20 April 1999 CopyrightCopyright © 1999 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...