Management of Atrial Fibrillation
Authors: David Matchar
Journal: Annals of Internal Medicine (1994)

Letters15 September 1994Management of Atrial FibrillationDavid Matchar, Doug McCrory, and Edward L. C. PritchettDavid MatcharDuke University Center for Health Policy Research and Education, Durham, NC 27708. Duke University Medical Center, Durham, NC 27710. Durham Veterans Administration Medical Center, Durham, NC 27705Search for more papers by this author, Doug McCroryDuke University Center for Health Policy Research and Education, Durham, NC 27708. Duke University Medical Center, Durham, NC 27710. Durham Veterans Administration Medical Center, Durham, NC 27705Search for more papers by this author, and Edward L. C. PritchettDuke University Center for Health Policy Research and Education, Durham, NC 27708. Duke University Medical Center, Durham, NC 27710. Durham Veterans Administration Medical Center, Durham, NC 27705Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-121-6-199409150-00029 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In their article on the management of chronic asymptomatic atrial fibrillation, Disch and colleagues [1] used a decision model to conclude that low-dose amiodarone or quinidine would be preferred over warfarin, primarily through a reduction in stroke risk [1]. They concluded this in the context of several clinical trials showing the effectiveness of warfarin in reducing stroke risk in patients with atrial fibrillation [2] but had no clinical trial data supporting the effectiveness of quinidine, amiodarone, or any other antiarrhythmic agent for this purpose.Their conclusion appears to hinge on two subtle assumptions embedded in the structure ...References1. 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. Google Scholar2. Matchar DB, McCrory DC, Barnett HJ, Feussner JR. Medical treatment for stroke prevention. Ann Intern Med. 1994; 121:41-53. Google Scholar3. Page RL, Wilkinson WE, Clair WK, McCarthy EA, Pritchett EL. Asymptomatic arrhythmias in patients with symptomatic paroxysmal atrial fibrillation and paroxysmal supraventricular tachycardia. Circulation. 1994; 89:224-7. Google Scholar4. Stroke Prevention in Atrial Fibrillation Investigators. Predictors of thromboembolism in atrial fibrillation: I. Clinical features of patients at risk. Ann Intern Med. 1992; 116:1-5. Google Scholar Author, Article, and Disclosure InformationAffiliations: Duke University Center for Health Policy Research and Education, Durham, NC 27708. Duke University Medical Center, Durham, NC 27710. Durham Veterans Administration Medical Center, Durham, NC 27705 PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics 15 September 1994Volume 121, Issue 6Page: 466-467KeywordsAtrial fibrillationCardiovascular therapyClinical trialsElectrocardiographyMedical risk factorsStroke Issue Published: 15 September 1994 Copyright & PermissionsCopyright © 1994 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...