Author/Editor		Bombek, Mirko
Title		Farmakološko zdravljenje atrijske fibrilacije
Translated title		Pharmacologic treatment of atrial fibrillation
Type		članek
Source		In: Hojs R, Krajnc I, editors. Zbornik predavanj in praktikum 10. srečanje internistov in zdravnikov splošne medicine Iz prakse za prakso z mednarodno udeležbo; 1999 maj 21-22; Maribor. Maribor: Spošna bolnišnica Maribor,
Publication year		1999
Volume		str. 139-52
Language		slo
Abstract		Atrial fibrillation (AF) is a frequent form of supraventricular arrhythmia. We haveto decidewhetherto convert AFand maintain the attained sinus rhythm, prevent attacks or, in case this is not possible, to control the ventricular rate in order to reach a satisfactory clinical state. We must also contemplate complementary treatment with anticoagulant and/or antiaggregation drugs. Frequently AF is triggered by external factors. Aftertheir elimination it is often not necessary to maintain sinus rhythm with antiarrhythmics. Antiarrhythmics of the I.C. group are suitable for pharmacologic cardioversion, f.ex. propaphenon (successful in 60-80%ofcases) ifthere are no contraindications, or amiodarone. In long-term AF, rhythm electroconversion is safer and more successful. For the maintenance of sinus rhythm group I drugs as well as sotalol are most often used, in cases of contraindications and refractory AF amiodarone is applied with a 60-70 % success. For ventricular rate control digitalis is applied, b blockers and Ca antagonists underconsideration of additional indications. Due to their proarrhythmic and negatively inotropic effect antiarrhythmics are neither ideal nor safe drugs, therefore the nonpharmacologic approach is prevailing. It has not been elucidated whether we should attempt to achieve sinus rhythm at any cost or be content merelywith ventricular rate control (attained by any method) when sinus rhythm cannot be attained.
Descriptors		ATRIAL FIBRILLATION ANTI-ARRHYTHMIA AGENTS