CONTROVERSIES AND RESEARCH IN ATRIAL FIBRILLATION
Abstract:
The last years have been the witnesses of the significant changes in the management of patients
with cardiac arrhythmias. Electrophysiology has evolved from a purely descriptive discipline to the
international territory where the procedure finding the last fifteen years improved survival and quality of
life in a large number of patients. Atrial fibrillation in the last years become a topic of major interest,
presenting a series of controversies about the clinical, pathological and therapeutic issues. Sustained
data show us that atrial fibrillation ranks as the second most common cause of cardiac arrhythmias. It is
more common in men than in women, and its prevalence increases with age. Mortality in patients with
atrial fibrillation is two times higher compared to people who have sinus rhythm. Several studies have
investigated the relationship between the atrial fibrillation and diabetes, the link between this cardiac
arrhythmias and Alzheimer disease. As a result of observations, although the efficacy of amiodarone
compared with most other drugs were higher in arrhythmias treatment it was decided to develop a
treatment algorithm for the maintenance of the sinus rhythm that tailored initial drug therapy to
maximize safety. Both the loss of synchronous atrial activity and ventricular rate irregularity affects
cardiac output. Uncommanded rapid ventricular frequency, usually > 130/min, may develop heart
dilatation with global hypokinesia and ventricular dysfunction, a condition called tachycardiomyopathy.
This form of cardiomyopathy is reversible to adequate control of ventricular frequency or to restore the
sinus rhythm.
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