Atrial fibrillation, part 2: How to use antiarrhythmics and anticoagulants

J. V. Jayachanoran, J. E. Olgin, D. P. Zipes

Research output: Contribution to journalArticle

Abstract

Long-term oral antiarrhythmic therapy, attempting to maintain sinus rhythm, is warranted for some patients with atrial fibrillation (AF) and severe symptoms, even though efficacy is limited and proarrhythmia is a concern. Class IC agents, including flecainide and propafenone, are well tolerated at the usual dosages. The class III agent sotalol has β-blocking activity that may be useful in specific cases. Despite serious side effects, amiodarone can provide a reasonable balance of benefit and risk with proper patient selection, dosing, and follow-up. In the absence of specific contraindications, anticoagulant therapy to prevent thromboembolism is warranted for all patients with AF. Warfarin is recommended for high-risk patients; aspirin is appropriate for those at low risk.

Original languageEnglish (US)
Pages (from-to)185-195
Number of pages11
JournalJournal of Critical Illness
Volume14
Issue number4
StatePublished - Jun 16 1999

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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