Rhythm Control in AF: Have We Reached the Last Frontier?

AF is a worldwide epidemic, affecting approximately 33 million people, and its rising prevalence is expected to account for increasing clinical and public health costs. AF is associated with an increased risk of MI, heart failure, stroke, dementia, chronic kidney disease and mortality. Preserving si...

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Main Author: Gheorghe-Andrei Dan
Format: Article
Language:English
Published: Radcliffe Medical Media 2019-07-01
Series:European Cardiology Review
Online Access:https://www.ecrjournal.com/articles/rhythm-control-in-atrial-fibrillation
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author Gheorghe-Andrei Dan
author_facet Gheorghe-Andrei Dan
author_sort Gheorghe-Andrei Dan
collection DOAJ
description AF is a worldwide epidemic, affecting approximately 33 million people, and its rising prevalence is expected to account for increasing clinical and public health costs. AF is associated with an increased risk of MI, heart failure, stroke, dementia, chronic kidney disease and mortality. Preserving sinus rhythm is essential for a better outcome. However, because of the inherent limits of both pharmacological and interventional methods, rhythm strategy management is reserved for symptom and quality-of-life improvement. While ‘classical’ antiarrhythmic drug therapy remains the first-line therapy for rhythm control, its efficacy and safety are limited by empirical use, proarrhythmic risk and organ toxicity. Ablative techniques have had an impressive development, but AF ablation still failed to demonstrate a significant impact on hard endpoints. Understanding of the complex mechanisms of AF will help to develop new vulnerable targets to therapy. Promising molecules are under development, intended to fill the gap between the current pharmacological treatment aimed at maintaining sinus rhythm and the expectations from rhythm strategy.
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spelling doaj-art-89e0833035cd402797df4c1d51aaa7ef2025-08-20T02:39:22ZengRadcliffe Medical MediaEuropean Cardiology Review1758-37561758-37642019-07-01142778110.15420/ecr.2019.8.1Rhythm Control in AF: Have We Reached the Last Frontier?Gheorghe-Andrei Dan0Carol Davila University of Medicine and Pharmacy, Bucharest, Romania; Colentina University Hospital, Bucharest, RomaniaAF is a worldwide epidemic, affecting approximately 33 million people, and its rising prevalence is expected to account for increasing clinical and public health costs. AF is associated with an increased risk of MI, heart failure, stroke, dementia, chronic kidney disease and mortality. Preserving sinus rhythm is essential for a better outcome. However, because of the inherent limits of both pharmacological and interventional methods, rhythm strategy management is reserved for symptom and quality-of-life improvement. While ‘classical’ antiarrhythmic drug therapy remains the first-line therapy for rhythm control, its efficacy and safety are limited by empirical use, proarrhythmic risk and organ toxicity. Ablative techniques have had an impressive development, but AF ablation still failed to demonstrate a significant impact on hard endpoints. Understanding of the complex mechanisms of AF will help to develop new vulnerable targets to therapy. Promising molecules are under development, intended to fill the gap between the current pharmacological treatment aimed at maintaining sinus rhythm and the expectations from rhythm strategy.https://www.ecrjournal.com/articles/rhythm-control-in-atrial-fibrillation
spellingShingle Gheorghe-Andrei Dan
Rhythm Control in AF: Have We Reached the Last Frontier?
European Cardiology Review
title Rhythm Control in AF: Have We Reached the Last Frontier?
title_full Rhythm Control in AF: Have We Reached the Last Frontier?
title_fullStr Rhythm Control in AF: Have We Reached the Last Frontier?
title_full_unstemmed Rhythm Control in AF: Have We Reached the Last Frontier?
title_short Rhythm Control in AF: Have We Reached the Last Frontier?
title_sort rhythm control in af have we reached the last frontier
url https://www.ecrjournal.com/articles/rhythm-control-in-atrial-fibrillation
work_keys_str_mv AT gheorgheandreidan rhythmcontrolinafhavewereachedthelastfrontier