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Making Sense of the Maze
Which Patients With Atrial Fibrillation Will Benefit?
Thoralf M. Sundt, MD;
Bernard J. Gersh, MBChB, DPhil
JAMA. 2005;294:2357-2359.
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Atrial fibrillation imposes heavy burdens on both patients and clinical practice. Approximately 2.3 million individuals in the United States have atrial fibrillation and the advancing age of the population,1-2 along with the increasing prevalence of obesity,3 is likely to further expand this number. Recent clinical trials have provided valuable information regarding management strategies of rate control with anticoagulation as opposed to the maintenance of sinus rhythm, primarily by the use of antiarrhythmic drugs. In general, not only has maintenance of sinus rhythm proven no better than rate control,4 but the AFFIRM trial actually demonstrated a benefit of rate control over rhythm control in terms of overall mortality among patients with coronary artery disease and hypertension.5 Nonetheless certain patients most likely to benefit from coordinated atrioventricular contraction were underrepresented in these trials, including patients with severe symptoms, hypertrophic cardiomyopathy, severe heart failure, . . . [Full Text of this Article]
Author Affiliations: Divisions of Cardiovascular Surgery (Dr Sundt) and Cardiovascular Diseases (Dr Gersh), Mayo Clinic, Rochester, Minn.
RELATED ARTICLE
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George Doukas, Nilesh J. Samani, Christos Alexiou, Mehmet Oc, Derek T. Chin, Peter G. Stafford, Leong L. Ng, and Tomasz J. Spyt
JAMA. 2005;294(18):2323-2329.
ABSTRACT
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THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
Left-Atrial Ablation of AFib During Mitral Valve Surgery
Journal Watch Cardiology 2005;2005:1-1.
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