Antiarrhythmic Treatment in Atrial Fibrillation

Seema Ledan, PharmD


US Pharmacist. 2020;45(2):24-27. 

In This Article

Antiarrhythmic Management

Successful strategies to restore and maintain sinus rhythm have been shown to improve symptoms and quality of life; however, these strategies don't improve survival or reduce the risk of stroke.[1,6,7] The Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) study found no evidence to support the prevention of stroke or improvement in mortality with rhythm control when compared with a rate-control strategy. Also, a rhythm-control strategy may be associated with more hospitalizations, warranting its use only in appropriate candidates.[1] Persistent symptoms associated with AF, difficulty achieving adequate rate control, younger patients, first episode of AF, tachycardia-mediated cardiomyopathy, and AF precipitated by an acute illness may indicate the need for rhythm-control management.[1] Early intervention with rhythm-control strategy to prevent progression of AF has also been shown to be beneficial.[1,8–10]