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The current treatment strategy for atrial fibrillation: a difficult path to proving the axiom

DOI: https://doi.org/10.29296/25877305-2022-07-02

Professor S. Kanorsky, MD
Kuban State Medical University, Krasnodar

Atrial fibrillation (AF) reduces patient performance and increases morbidity and mortality. The early 21st century studies failed to establish the benefits of the AF treatment strategy aimed at restoring and maintaining sinus rhythm versus the ventricular rate-lowering strategy for persistent AF. Because of this, for two decades it was preferable to refuse to restore sinus rhythm in the treatment of patients with AF. Improving drug therapy and catheter ablation techniques can reduce the risk of adverse cardiovascular outcomes with early sinus rhythm control in AF. The review presents the most interesting results of recent clinical trials and recommendations concerning various methods of AF treatment; data on the efficiency and safety of antiarrhythmic drug therapy and catheter ablation, including those obtained by their direct comparison. It deals with the problems of applying the sinus rhythm control strategy in patients with AF and heart failure, the risk and benefits of treatment with Classes IC and III antiarrhythmic drugs. In the future, the widespread use of actively developing therapies to control sinus rhythm will help patients with AF reduce the incidence of symptoms and complications of this arrhythmia.

atrial fibrillation
antiarrhythmic drugs
catheter ablation
sinus rhythm control

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