Current approaches in atrial fibrillation treatment

Öz

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice. Its incidence increases with age. AF is classified into subtypes according to the duration and/or able to provide sinus rhytym. İnitially, patients should be evaluated for rhythm or rate control for appropriate treatment. Second stage of strategy aimed to investigate the feasibility of anticoagulation therapy. Recently, due to the progress made in treatment with rhythm control and anticoagulation therapy, either American or European guidelines have been renovated. These developments have taken place in the newly published guide. In this article, the current change in the management of AF is discussed.

Anahtar Kelimeler

• atrial fibrillation, rhythm, anticoagulation

Atriyal fibrilasyon tedavisinde güncel yaklaşımlar

Öz

Atriyal fibrilasyon (AF) klinik pratikte en sık görülen disritmi olup insidansı yaşla birlikte artış göstermektedir. Sinüs ritminini sağlayabilmeye ve oluşum süresine göre AF sınıflandırılmaktadır. Tedavi, ilk olarak hastaların ritm kontrolü veya hız kontrolü açısından uygunluğunun değerlendirilmesiyle başlar. Strateji belirlendikten sonra ikinci aşamada antikoagülan tedavinin gerekliliği araştırılır. Son zamanlarda hem ritm kontrolü hem de antikoagülan tedavide kaydedilen gelişmeler gerek Amerikan gerekse Avrupa kılavuzlarının birbiri ardına yenilenmesini gerekli kılmıştır. Bu gelişmeler yeni yayınlanan kılavuzlarda yerini almış olup bu yazıda atriyal fibrilasyon tedavisinde yaşanan bu güncel değişimler ele alınmıştır.

Anahtar Kelimeler

• Atriyal fibrilasyon, ritim, antikoagülasyon

Kaynakça

1. Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the man- agement of atrial fibrillation: the Task Force for the Man- agement of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace 2010;12:1360-1420.
2. Uyarel H, Onat A, Yuksel H, et al. Incidence, prevalence, and mortality estimates for chronic atrial fibrillation in Turkish adults. Turk Kardiyol Dern Ars 2008;36:214-222
3. Haïssaguerre M, Jaïs P, Shah DC, et al. Spontaneous initia- tion of atrial fibrillation by ectopic beats originating in the pulmonary veins.. N Engl J Med 1998; 339:659-666
4. Kopecky SL, Gersh BJ, McGoon MD, et al. The natural his- tory of lone atrial fibrillation. A population-based study over three decades. N Engl J Med. 1987;317:669-674.
5. Camm AJ, Lip GY, De Caterina R, et al. 2012 focused up- date of the ESC Guidelines for the management of atrial fibrillation: an update of the 2010 ESC Guidelines for the management of atrial fibrillation-developed with the spe- cial contribution of the European Heart Rhythm Associa- tion. Europace 2012;14:1385-413.
6. Ryder KM, Benjamin EJ. Epidemiology and significance of atrial fibrillation. J Am Cardiol 1999;84:131-138.
7. Van Gelder IC, Hagens VE, Bosker HA, et al. A comparison of rate control and rhythm control in patients with recurrent persistent atrial fibrillation. N Engl J Med 2002;347:1834- 1840.
8. Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibril- lation. N Engl J Med 2002;347:1825-1833.

9. Hagens VE, Ranchor AV, Van Sonderen E, et al. Effect of rate or rhythm control on quality of life in persistent atrial fibril- lation. Results from the Rate Control Versus Electrical Car- dioversion (RACE) Study. J Am Coll Cardiol 2004;43:241- 247.
10. Gronefeld GC, Lilienthal J, Kuck KH, Hohnloser SH. Impact of rate versus rhythm control on quality of life in patients with persistent atrial fibrillation. Results from a prospective randomized study. Eur Heart J 2003;24:1430- 1436.
11. Carlsson J, Miketic S, Windeler J, et al. Randomized trial of rate- control versus rhythm-control in persistent atrial fi- brillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. J Am Coll Cardiol 2003;41:1690-1696.
12. Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient ver- sus strict rate control in patients with atrial fibrillation. N Engl J Med 2010;362:1363-1373.
13. Gillis AM, Burland L, Arnburg B, et al. Treating the right patient at the right time: an innovative approach to the man- agement of atrial fibrillation. Can J Cardiol 2008;24:195-8.
14. Gillis AM. Selective pacing algorithms for prevention of atrial fibrillation: the final chapter? Heart Rhythm 2009;6:295-301.
15. Camm J A, Kirchhof P, Gregory Y.H, et al. Guidelines of atrial fibrillation treatment. Eur Heart Jl 2010;2369-2429
16. Kİber L, Torp-Pedersen C, McMurray JJ, et al. Dronedarone Study Group. Increased mortality after dronedarone thera- py for severe heart failure. N Engl J Med 2008;358:2678- 2687.
17. Connolly SJ, Camm AJ, Halperin JL, et al; PALLAS Inves- tigators. Dronedarone in high-risk permanent atrial fibrilla- tion. N Engl J Med 2011;365:2268-2276.
18. Roy D, Rowe BH, Stiell IG, et al; CRAFT Investigators. A randomized, controlled trial of RSD1235, a novel anti- arrhythmic agent, in the treatment of recent onset atrial fi- brillation. J Am Coll Cardiol 2004;44:2355-2361.
19. Stiell IG, Roos JS, Kavanagh KM, Dickinson G. A mul- ticenter, open-label study of vernakalant for the con- version of atrial fibrillation to sinus rhythm. Am Heart J 2010;159:1095-1101.
20. Camm AJ, Capucci A, Hohnloser SH, et al; AVRO Investi- gators. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent- onset atrial fibrillation. J Am Coll Cardiol 2011;57:313-321.
21. Ricard P, Lévy S, Trigano J, et al.Prospectiveassessment of the minimum energy needed for external cardioversion of atrial fibrillation. J Am Cardiol 1997;79:815-816.
22. Joglar JA, Hamdan MH, Ramaswamy K, et al. Initial en- ergy for elective external cardioversion of persistent atrial fibrillation. J Am Cardiol 2000;86:348-350.
23. Levy S, Lacombe P, Cointe R, Bru P. High energy jour- nal of the national medical association transcatheter car- dioversion of chronic atrial fibrillation. J Am Coll Cardiol 1988;12:514-518.
24. Vaziri SM, Larson MG, Benjamin EJ, Levy D. Echocardio- graphicpredictors of nonrheumatic atrial fibrillation. The Framingham Study. Circulation 1994;89:724-730.
25. Packer DL, Kowal RC, Wheelan KR, et al; STOP AF Cryo- ablation Investigaters. Reply: CryoBalloon ablation: first results of North American STOP AF pivotal trial. J Am Coll Cardiol 2013;62:1307-1308.
26. Andrade JG, Khairy P, Guerra PG, et al. Efficacy and safety of cryoballoon ablation for atrial fibrillation: a systematic review of published studies. Heart Rhythm 2011; 8:1444- 1451.
27. Senatore G, Stabile G, Bertaglia E, et al. Role of transtele- phonic electrocardiographic monitoring in detecting short- term arrhythmia recurrences after radiofrequency abla- tion in patients with atrial fibrillation. J Am Coll Cardiol 2005;45:873-876.
28. Cosedis Nielsen J, Johannessen A, Raatikainen P, et al. Ra- diofrequency ablation as initial therapy in paroxysmal atrial fibrillation. N Engl J Med 2012: 25;367:1587-1595.
29. Pison L, La Meir M, van Opstal J, et al. Hybrid thoraco- scopic surgical and transvenous catheter ablation of atrial fibrillation. J Am Coll Cardiol 2012;60:54-61.
30. Falk RH, Knowlton AA, Bernard SA, et al. Digoxin for converting recent-onset atrial fibrillation to sinus rhythm. A randomized double-blinded trial. Ann Intern Med. 1987;106:503-506.
31. Wazni OM, Marrouche NF, Martin DO, et al. Radiofrequen- cy ablation vs antiarrhythmic drugs as first-line treatment of symptomatic atrial fibrillation: a randomized trial. J Am Med Association 2005 Jun 1;293:2634-2640.
32. Jaïs P, Cauchemez B, Macle L, et al. Catheter ablation ver- sus antiarrhythmic drugs for atrial fibrillation: the A4 study. Circulation 2008;118:2498-505.
33. Packer DL, Kowal RC, Wheelan KR, et al. STOP AF Cryo- ablation Investigators. J Am Coll Cardiol. 2013:1;62:1307- 1308.
34. Wilber DJ, Pappone C, Neuzil P, et al; Thermo Cool AF Trial Investigators. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. J Am Med Association 2010;303:333-340.
35. Stabile G, Bertaglia E, Turco P, et al. Role of pulmonary veins isolation in persistent atrial fibrillation ablation: the pulmonary vein isolation in persistent atrial fibrillation (PIPA) study. Pacing Clin Electrophysiol 2009;32:S116- 119.
36. Roldan V, Marin F, Manzaro-Fernandez S, et al. The HAS- BLED score has better prediction accuracy for major bleed- ing than CHADS2 or CHA2DS2-VASc scores in antico- agulated patients with atrial fibrillation. J Am Coll Cardiol 2013:10;62:2199-204.
37. Olesen JB, Lip GY, Hansen ML, et al. Validation of risk stratification schemes for predicting stroke and thrombo- embolism in patients with atrial fibrillation: nationwide co- hort study. Br Med J 2011;342.
38. Ertaş F, Kaya H, Kaya Z, et al. The atrial fibrillation in Turkey: Epidemiologic Registry (AFTER). Cardiol J 2013;20:447-452.
39. Ellis DJ, Usman MH, Milner PG, et al. The first evaluation of a novel vitamin K antagonist, Tecarfarin, in patients with atrial fibrillation. Circulation 2009;120:1029-1035
40. Veyrat-Follet C, Vivier N, Trellu M, et al. The pharmaco- kinetics of idraparinux, a long-acting indirect factor Xa in- hibitor: population pharmacokinetic analysis from Phase III clinical trials. J Thromb Haemost 2009;7:559-56.5
41. Paty I, Trellu M, Destors JM, et al. Reversibility of the anti- FXa activity of idrabiotaparinux (biotinylated idraparinux) by intravenous avidin infusion. J Thromb Haemost 2010;8:722-729.
42. Patel MR, Mahaffey KW, Garg J, et al; ROCKET AF In- vestigators. Rivaroxaban vs. warfarin in nonvalvular atrial fibrillation. N Engl J Med 2011;365:883-891.
43. Halvorsen S, Atar D, Yang H, et al; ARISTOTLE Investig- tors. Efficacy and safety of apixaban compared with warfa- rin according to age for stroke prevention in atrial fibrilla- tion: observations from the ARISTOTLE trial. Eur Heart J 2014 Feb 20.]
44. Ruff CT, Giugliano RP, Antman EM, et al. Evaluation of the novel factor Xa inhibitor edoxaban compared with war- farin in patients with atrial fibrillation: design and rationale for the Effective aNticoaGulation with factor Xa next gen- eration in Atrial Fibrillation-Thrombolysis In Myocardial Infarction study 48 (ENGAGE AF-TIMI 48). Am Heart J 2010;160:635-641.
45. Connolly SJ, Ezekowitz MD, Yusuf S, et al; RE-LY Steer- ing Com- mittee and Investigators. Dabigatran vs. war- farin in patients with atrial fibrillation. N Engl J Med 2009;361:1139-1151.
46. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Newly identified events in the RE-LY trial. N Engl J Med 2010;363:1875- 1876.
47. Loke YK, Pradhan S, Yeong JK, Kwok CS. Comparative coronary risks of apixaban, rivaroxaban and dabigatran: a meta-analysis and adjusted indirect comparison. Br J Clin Pharmacol 2014. [Epub ahead of print]
48. Lip GY, Tse HF, Lane DA. Atrial fibrillation. Lancet 2012;379:648-661.
49. Holmes DR, Reddy VY, Turi ZG, et al. Percutaneous clo- sure of the left atrial appendage vs. warfarin therıapy for prevention of stroke in patients with atrial fibrillation: a randomised noninferiority trial. Lancet 2009;374:534-542.