Management of Atrial Fibrillation: Simplicity Surrounded by Controversy
Authors: Eric N. Prystowsky
Journal: Annals of Internal Medicine (1997)

Editorials1 February 1997Management of Atrial Fibrillation: Simplicity Surrounded by ControversyEric N. Prystowsky, MDEric N. Prystowsky, MDNorthside Cardiology, Indianapolis, IN 46260Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-126-3-199702010-00012 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Atrial fibrillation appears to be the most common sustained tachyarrhythmia encountered in clinical practice; it increases in frequency with age and the presence of structural heart disease [1]. It has neither the glamour of the Wolff-Parkinson-White syndrome nor the drama of sudden cardiac death, and it appears to be simple to treat. Yet no other arrhythmia is surrounded by so much controversy with regard to management strategies.Three major tenets govern therapy for atrial fibrillation: maintenance of sinus rhythm, control of ventricular rate, and prevention of thromboembolism. The relative benefit of sinus rhythm over a controlled fibrillating rate is controversial. ...References1. Prystowsky EN, Benson DW Jr, Fuster V, Hart RG, Kay GN, Myerburg RJ, et al. Management of patients with atrial fibrillation. A statement for healthcare professionals. From the Subcommittee on Electrocardiography and Electrophysiology, American Heart Association. Circulation. 1996; 93:1262-77. Google Scholar2. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995; 92:1954-68. Google Scholar3. Davies MJ, Pomerance A. Pathology of atrial fibrillation in man. Br Heart J. 1972; 34:520-5. Google Scholar4. Prystowsky EN, Klein GJ. 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Google Scholar Author, Article, and Disclosure InformationAffiliations: Northside Cardiology, Indianapolis, IN 46260Corresponding Author: Eric N. Prystowsky, MD, Northside Cardiology, 8333 Naab Road, Indianapolis, IN 46260. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoCardioversion Guided by Transesophageal Echocardiography: The ACUTE Pilot Study: A Randomized, Controlled Trial Allan L. Klein , Richard A. Grimm , Ian W. Black , Dominic Y. Leung , Mina K. Chung , Susan E. Vaughn , R. Daniel Murray , Dave P. Miller , and Kristopher L. Arheart Metrics Cited ByNeurologic complications of arrhythmia treatmentA review of the class III antiarrhythmic agents and their uses and implications for patient managementUse of Transesophageal Echocardiography to Guide Cardioversion in Patients with Atrial FibrillationRole of transesophageal echocardiography-guided cardioversion of patients with atrial fibrillationCost Effectiveness of Therapies for Atrial FibrillationManagement of atrial fibrillation: therapeutic options and clinical decisionsTransesophageal Echocardiography-Guided Cardioversion of Atrial FibrillationRisk of Thromboembolism in Acute Atrial Fibrillation or Atrial FlutterCost-Effectiveness of Therapy in Nonatrial FibrillationEdward Catherwood, MD, MS and Mark L. Greenberg, MDCost-Effectiveness of Cardioversion and Antiarrhythmic Therapy in Nonvalvular Atrial FibrillationEdward Catherwood, MD, MS, W. David Fitzpatrick, MD, Mark L. Greenberg, MD, Peter T. Holzberger, MD, David J. Malenka, MD, Barbara R. Gerling, MD, and John D. Birkmeyer, MDPerspectives and controversies in atrial fibrillationDesign of a Clinical Trial for the Assessment of Cardioversion Using Transesophageal Echocardiography (The ACUTE Multicenter Study) 11This study was supported in part by grants from the American Medical Association Education and Research Foundation, Chicago, Illinois; and American Society of Echocardiography Outcomes Research, Raleigh, North Carolina.What Have We Learned from the US Experience on the Prophylactic Use of ICDs Following MADIT? 1 February 1997Volume 126, Issue 3Page: 244-246KeywordsArrhythmiaAtrial fibrillationDrug therapyInternational normalized ratioIschemic strokeOutpatientsShockStrokeThromboembolismThrombosis Issue Published: 1 February 1997 CopyrightCopyright © 1997 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...