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Journal of Cardiovascular Pharmacology and Therapeutics
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Clinical Review : Update on Atrial Fibrillation: Restoration of Sinus Rhythm or Ventricular Rate Control?

Yi-Gang Li

Department of Medicine, Division of Cardiology, J.W. Goethe University, Frankfurt, Germany

Stefan H. Hohnloser

Department of Medicine, Division of Cardiology, J.W. Goethe University, Frankfurt, Germany

In patients with persistent atrial fibrillation, two therapeutic alternatives exist, namely res toration and maintenance of sinus rhythm versus ventricular rate control combined with anticoagulation. Currently, the selection of the best therapeutic strategy in an individual patient relies for the most part on clinical judgement and personal experience. At present, there are no prospective scientific data to support the superiority of one treatment over the other with respect to overall survival or quality of life. This review summarizes the present knowledge on this important clinical problem with particular emphasis on issues such as efficacy of antiarrhythmic drugs to prevent recurrent atrial fibrillation, proarrhythmic haz ards of these compounds, or efficacy and safety of anticoagulation in nonrheumatic atrial fibrillation. These data serve as the basis of ongoing clinical trials prospectively comparing the merits and demerits of the two therapeutic strategies in the most common arrhythmia encountered in clinical practice.

Key Words: atrial fibrillation • drug therapy • cardioversion • heart rate control.

Journal of Cardiovascular Pharmacology and Therapeutics, Vol. 3, No. 2, 185-194 (1998)
DOI: 10.1177/107424849800300211
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