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Non-surgical Treatment and Prevention of Atrial Fibrillation

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Electrical Diseases of the Heart

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Abstract

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. Electrical, contractile and structural remodeling of the left atrium underlies the development of AF. AF can be classified as paroxysmal if the arrhythmia terminates within 7 days, persistent if it lasts longer than 7 days, or permanent if cardioversion was not attempted or failed. AF can be further classified according to mechanism of initiation. In general, AF can be expected to recur, although the pattern and tempo of recurrence is widely variable. AF is considered recurrent after two or more episodes, regardless of whether the patient is symptomatic.

Initial diagnosis of AF should include a thorough evaluation including family history of arrhythmia, structural heart disease and thyroid disorders. Management of new-onset AF may include electrical or pharmacologic cardioversion. Chronic management emphasizes symptom control and prevention of heart failure and thromboembolic disease through either a rate or rhythm control strategy and anticoagulation. For those who remain symptomatic, catheter ablation or surgical Maze procedure may be considered. As conventional antiarrhythmic medications are limited by efficacy and side effects, efforts are underway to identify therapeutics aimed at preventing conditions associated with the development of AF including hypertension and arrhythmogenic remodeling.

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References

  1. Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and risk factors in atrial fibrillation (ATRIA) study. JAMA. 2001;285:2370–5.

    Article  PubMed  CAS  Google Scholar 

  2. Miyasaka Y, Barnes ME, Gersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted county, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114:119–25.

    Article  PubMed  Google Scholar 

  3. Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27:949–53.

    Article  PubMed  Google Scholar 

  4. Borzecki AM, Bridgers DK, Liebschutz JM, Kader B, Kazis LE, Berlowitz DR. Racial differences in the prevalence of atrial fibrillation among males. J Natl Med Assoc. 2008;100:237–45.

    PubMed  Google Scholar 

  5. Kannel WB, Wolf PA, Benjamin EJ, Levy D. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82:2N–9N.

    Article  PubMed  CAS  Google Scholar 

  6. Soliman EZ, Alonso A, Goff Jr DC. Atrial fibrillation and ethnicity: the known, the unknown and the paradox. Future Cardiol. 2009;5:547–56.

    Article  PubMed  Google Scholar 

  7. Fuster V, Ryden LE, Asinger RW, et al. ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation: executive summary a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for practice guidelines and policy conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) Developed in collaboration with the North American society of pacing and electrophysiology. Circulation. 2011;104:2118–50.

    PubMed  CAS  Google Scholar 

  8. Das S, Makino S, Melman YF, et al. Mutation in the S3 segment of KCNQ1 results in familial lone atrial fibrillation. Heart Rhythm. 2009;6:1146–53.

    Article  PubMed  Google Scholar 

  9. Peng S, Publicover NG, Airey JA, et al. Diffusion of single cardiac ryanodine receptors in lipid bilayers is decreased by annexin 12. Biophys J. 2004;86:145–51.

    Article  PubMed  CAS  Google Scholar 

  10. Levy S. Factors predisposing to the development of atrial fibrillation. Pacing Clin Electrophysiol. 1997;20:2670–4.

    Article  PubMed  CAS  Google Scholar 

  11. Zimetbaum PJ, Josephson ME, editors. Practical clinical electrophysiology. Philadelphia: Lippincott Williams & Wilkins; 2009.

    Google Scholar 

  12. Zimetbaum PJ, Josephson ME, McDonald MJ, et al. Incidence and predictors of myocardial infarction among patients with atrial fibrillation. J Am Coll Cardiol. 2000;36:1223–7.

    Article  PubMed  CAS  Google Scholar 

  13. Dries DL, Exner DV, Gersh BJ, Domanski MJ, Waclawiw MA, Stevenson LW. Atrial fibrillation is associated with an increased risk for mortality and heart failure progression in patients with asymptomatic and symptomatic left ventricular systolic dysfunction: a retrospective analysis of the SOLVD trials. Studies of left ventricular dysfunction. J Am Coll Cardiol. 1998;32:695–703.

    Article  PubMed  CAS  Google Scholar 

  14. Massie BM, Fisher SG, Radford M, et al. Effect of amiodarone on clinical status and left ventricular function in patients with congestive heart failure. CHF-STAT investigators. Circulation. 1996;93:2128–34.

    Article  PubMed  CAS  Google Scholar 

  15. Pedersen OD, Brendorp B, Elming H, Pehrson S, Kober L, Torp-Pedersen C. Does conversion and prevention of atrial fibrillation enhance survival in patients with left ventricular dysfunction? evidence from the Danish investigations of arrhythmia and mortality ON dofetilide/(DIAMOND) study. Card Electrophysiol Rev. 2003;7:220–4.

    Article  PubMed  Google Scholar 

  16. Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE. The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba follow-up study. Am J Med. 1995;98:476–84.

    Article  PubMed  CAS  Google Scholar 

  17. Flegel KM, Shipley MJ, Rose G. Risk of stroke in non-rheumatic atrial fibrillation. Lancet. 1987;1:526–9.

    Article  PubMed  CAS  Google Scholar 

  18. Wijffels MC, Kirchhof CJ, Dorland R, Allessie MA. Atrial fibrillation begets atrial fibrillation. A study in awake chronically instrumented goats. Circulation. 1995;92:1954–68.

    Article  PubMed  CAS  Google Scholar 

  19. Nattel S, Frelin Y, Gaborit N, Louault C, Demolombe S. Ion-channel mRNA-expression profiling: insights into cardiac remodeling and arrhythmic substrates. J Mol Cell Cardiol. 2010;48:96–105.

    Article  PubMed  CAS  Google Scholar 

  20. Kostin S, Klein G, Szalay Z, Hein S, Bauer EP, Schaper J. Structural correlate of atrial fibrillation in human patients. Cardiovasc Res. 2002;54:361–79.

    Article  PubMed  CAS  Google Scholar 

  21. Allessie M, Ausma J, Schotten U. Electrical, contractile and structural remodeling during atrial fibrillation. Cardiovasc Res. 2002;54:230–46.

    Article  PubMed  CAS  Google Scholar 

  22. Burstein B, Nattel S. Atrial fibrosis: mechanisms and clinical relevance in atrial fibrillation. J Am Coll Cardiol. 2008;51:802–9.

    Article  PubMed  CAS  Google Scholar 

  23. Nattel S, Burstein B, Dobrev D. Atrial remodeling and atrial fibrillation: mechanisms and implications. Circ Arrhythm Electrophysiol. 2008;1:62–73.

    Article  PubMed  Google Scholar 

  24. Dorian P, Pinter A, Mangat I, Korley V, Cvitkovic SS, Beatch GN. The effect of vernakalant (RSD1235), an investigational antiarrhythmic agent, on atrial electrophysiology in humans. J Cardiovasc Pharmacol. 2007;50:35–40.

    Article  PubMed  CAS  Google Scholar 

  25. Fedida D, Orth PM, Chen JY, et al. The mechanism of atrial antiarrhythmic action of RSD1235. J Cardiovasc Electrophysiol. 2005;16:1227–38.

    Article  PubMed  Google Scholar 

  26. Roy D, Pratt CM, Torp-Pedersen C, et al. Vernakalant hydrochloride for rapid conversion of atrial fibrillation: a phase 3, randomized, placebo-controlled trial. Circulation. 2008;117:1518–25.

    Article  PubMed  CAS  Google Scholar 

  27. Roy D, Rowe BH, Stiell IG, et al. A randomized, controlled trial of RSD1235, a novel anti-arrhythmic agent, in the treatment of recent onset atrial fibrillation. J Am Coll Cardiol. 2004;44:2355–61.

    Article  PubMed  CAS  Google Scholar 

  28. Kowey PR, Dorian P, Mitchell LB, et al. Vernakalant hydrochloride for the rapid conversion of atrial fibrillation after cardiac surgery: a randomized, double-blind, placebo-controlled trial. Circ Arrhythm Electrophysiol. 2009;2:652–9.

    Article  PubMed  Google Scholar 

  29. Camm AJ, Capucci A, Hohnloser SH, et al. A randomized active-controlled study comparing the efficacy and safety of vernakalant to amiodarone in recent-onset atrial fibrillation. J Am Coll Cardiol. 2011;57:313–21.

    Article  PubMed  CAS  Google Scholar 

  30. Torp-Pedersen C, Raev DH, Dickinson G, Butterfield NN, Mangal B, Beatch GN. A randomized placebo-controlled study of Vernakalant (oral) for the prevention of atrial fibrillation recurrence post-cardioversion. Circ Arrhythm Electrophysiol. 2011;4(5):637–43.

    Article  PubMed  CAS  Google Scholar 

  31. Alboni P, Botto GL, Baldi N, et al. Outpatient treatment of recent-onset atrial fibrillation with the “pill-in-the-pocket” approach. N Engl J Med. 2004;351:2384–91.

    Article  PubMed  CAS  Google Scholar 

  32. Hauser TH, Pinto DS, Josephson ME, Zimetbaum P. Safety and feasibility of a clinical pathway for the outpatient initiation of antiarrhythmic medications in patients with atrial fibrillation or atrial flutter. Am J Cardiol. 2003;91:1437–41.

    Article  PubMed  Google Scholar 

  33. Singh BN, Singh SN, Reda DJ, et al. Amiodarone versus sotalol for atrial fibrillation. N Engl J Med. 2005;352:1861–72.

    Article  PubMed  CAS  Google Scholar 

  34. Resnekov L, McDonald L. Appraisal of electroconversion in treatment of cardiac dysrhythmias. Br Heart J. 1968;30:786–811.

    Article  PubMed  CAS  Google Scholar 

  35. Yu WC, Lin YK, Tai CT, et al. Early recurrence of atrial fibrillation after external cardioversion. Pacing Clin Electrophysiol. 1999;22:1614–9.

    Article  PubMed  CAS  Google Scholar 

  36. Schwartzman D, Musley SK, Swerdlow C, Hoyt RH, Warman EN. Early recurrence of atrial fibrillation after ambulatory shock conversion. J Am Coll Cardiol. 2002;40:93–9.

    Article  PubMed  Google Scholar 

  37. Fuster V, Ryden LE, Cannom DS, et al. ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines developed in partnership with the European Society of Cardiology and in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. J Am Coll Cardiol. 2011;57:e101–98.

    Article  PubMed  CAS  Google Scholar 

  38. Goli AK, Koduri M, Byrd RP, Mackall J. Acute pulmonary edema associated with direct current cardioversion in a structurally normal heart. Rev Cardiovasc Med. 2008;9:137–41.

    Article  PubMed  Google Scholar 

  39. Upshaw Jr CB. Hemodynamic changes after cardioversion of chronic atrial fibrillation. Arch Intern Med. 1997;157:1070–6.

    Article  PubMed  Google Scholar 

  40. Brignole M, Menozzi C, Gasparini M, et al. An evaluation of the strategy of maintenance of sinus rhythm by antiarrhythmic drug therapy after ablation and pacing therapy in patients with paroxysmal atrial fibrillation. Eur Heart J. 2002;23:892–900.

    Article  PubMed  CAS  Google Scholar 

  41. Carlsson J, Miketic S, Windeler J, et al. Randomized trial of rate-control versus rhythm-control in persistent atrial fibrillation: the strategies of treatment of atrial fibrillation (STAF) study. J Am Coll Cardiol. 2003;41:1690–6.

    Article  PubMed  Google Scholar 

  42. Hohnloser SH, Kuck KH, Lilienthal J. Rhythm or rate control in atrial fibrillation–pharmacological intervention in atrial fibrillation (PIAF): a randomised trial. Lancet. 2000;356:1789–94.

    Article  PubMed  CAS  Google Scholar 

  43. Opolski G, Torbicki A, Kosior DA, et al. Rate control vs rhythm control in patients with nonvalvular persistent atrial fibrillation: the results of the polish how to treat chronic atrial fibrillation (HOT CAFE) study. Chest. 2004;126:476–86.

    Article  PubMed  Google Scholar 

  44. 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;347:1834–40.

    Article  PubMed  Google Scholar 

  45. Wyse DG. Rhythm versus rate control trials in atrial fibrillation. J Cardiovasc Electrophysiol. 2003;14:S35–9.

    Article  PubMed  Google Scholar 

  46. Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347:1825–33.

    Article  PubMed  CAS  Google Scholar 

  47. Talajic M, Khairy P, Levesque S, et al. Maintenance of sinus rhythm and survival in patients with heart failure and atrial fibrillation. J Am Coll Cardiol. 2010;55:1796–802.

    Article  PubMed  Google Scholar 

  48. Zimetbaum P. Is rate control or rhythm control preferable in patients with atrial fibrillation? An argument for maintenance of sinus rhythm in patients with atrial fibrillation. Circulation. 2005;111:3150–6; discussion 6–7.

    Article  PubMed  Google Scholar 

  49. Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Europace. 2010;12:1360–420.

    Article  PubMed  Google Scholar 

  50. McNamara RL, Bass EB, Miller MR, et al. Management of new onset atrial fibrillation. Rockville: Agency for Healthcare Research and Quality; 2001.

    Google Scholar 

  51. Lafuente-Lafuente C, Mouly S, Longas-Tejero MA, Bergmann JF. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev 2007:CD005049.

    Google Scholar 

  52. Wegener FT, Ehrlich JR, Hohnloser SH. Dronedarone: an emerging agent with rhythm- and rate-controlling effects. J Cardiovasc Electrophysiol. 2006;17 Suppl 2:S17–20.

    Article  PubMed  Google Scholar 

  53. Finance O, Manning A, Chatelain P. Effects of a new amiodarone-like agent, SR 33589, in comparison to amiodarone, D, L-sotalol, and lignocaine, on ischemia-induced ventricular arrhythmias in anesthetized pigs. J Cardiovasc Pharmacol. 1995;26:570–6.

    Article  PubMed  CAS  Google Scholar 

  54. Manning A, Thisse V, Hodeige D, Richard J, Heyndrickx JP, Chatelain P. SR 33589, a new amiodarone-like antiarrhythmic agent: electrophysiological effects in anesthetized dogs. J Cardiovasc Pharmacol. 1995;25:252–61.

    Article  PubMed  CAS  Google Scholar 

  55. Manning AS, Bruyninckx C, Ramboux J, Chatelain P. SR 33589, a new amiodarone-like agent: effect on ischemia- and reperfusion-induced arrhythmias in anesthetized rats. J Cardiovasc Pharmacol. 1995;26:453–61.

    Article  PubMed  CAS  Google Scholar 

  56. Singh BN, Connolly SJ, Crijns HJ, et al. Dronedarone for maintenance of sinus rhythm in atrial fibrillation or flutter. N Engl J Med. 2007;357:987–99.

    Article  PubMed  CAS  Google Scholar 

  57. Le Heuzey JY, De Ferrari GM, Radzik D, Santini M, Zhu J, Davy JM. A short-term, randomized, double-blind, parallel-group study to evaluate the efficacy and safety of dronedarone versus amiodarone in patients with persistent atrial fibrillation: the DIONYSOS study. J Cardiovasc Electrophysiol. 2010;21:597–605.

    Article  PubMed  Google Scholar 

  58. Kober L, Torp-Pedersen C, McMurray JJ, et al. Increased mortality after dronedarone therapy for severe heart failure. N Engl J Med. 2008;358:2678–87.

    Article  PubMed  Google Scholar 

  59. Connolly SJ, Crijns HJ, Torp-Pedersen C, et al. Analysis of stroke in ATHENA: a placebo-controlled, double-blind, parallel-arm trial to assess the efficacy of dronedarone 400 mg BID for the prevention of cardiovascular hospitalization or death from any cause in patients with atrial fibrillation/atrial flutter. Circulation. 2009;120:1174–80.

    Article  PubMed  CAS  Google Scholar 

  60. Connolly SJ, Camm AJ, Halperin JL, et al. Dronedarone in high-risk permanent atrial fibrillation. N Engl J Med. 2011;365(24):2268–76.

    Article  CAS  Google Scholar 

  61. Scirica BM, Morrow DA, Hod H, et al. Effect of ranolazine, an antianginal agent with novel electrophysiological properties, on the incidence of arrhythmias in patients with non ST-segment elevation acute coronary syndrome: results from the metabolic efficiency with ranolazine for less ischemia in Non ST-elevation acute coronary syndrome thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36) randomized controlled trial. Circulation. 2007;116:1647–52.

    Article  PubMed  CAS  Google Scholar 

  62. Burashnikov A, Sicouri S, Di Diego JM, Belardinelli L, Antzelevitch C. Synergistic effect of the combination of ranolazine and dronedarone to suppress atrial fibrillation. J Am Coll Cardiol. 2010;56:1216–24.

    Article  PubMed  CAS  Google Scholar 

  63. Sicouri S, Burashnikov A, Belardinelli L, Antzelevitch C. Synergistic electrophysiologic and antiarrhythmic effects of the combination of ranolazine and chronic amiodarone in canine atria. Circ Arrhythm Electrophysiol. 2010;3:88–95.

    Article  PubMed  CAS  Google Scholar 

  64. Wu L, Guo D, Li H, et al. Role of late sodium current in modulating the proarrhythmic and antiarrhythmic effects of quinidine. Heart Rhythm. 2008;5:1726–34.

    Article  PubMed  Google Scholar 

  65. Wu L, Ma J, Li H, et al. Late sodium current contributes to the reverse rate-dependent effect of IKr inhibition on ventricular repolarization. Circulation. 2011;123:1713–20.

    Article  PubMed  CAS  Google Scholar 

  66. Orth PM, Hesketh JC, Mak CK, et al. RSD1235 blocks late INa and suppresses early afterdepolarizations and torsades de pointes induced by class III agents. Cardiovasc Res. 2006;70:486–96.

    Article  PubMed  CAS  Google Scholar 

  67. Haissaguerre M, Jais P, Shah DC, et al. Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med. 1998;339:659–66.

    Article  PubMed  CAS  Google Scholar 

  68. Calkins H, Reynolds MR, Spector P, et al. Treatment of atrial fibrillation with antiarrhythmic drugs or radiofrequency ablation: two systematic literature reviews and meta-analyses. Circ Arrhythm Electrophysiol. 2009;2:349–61.

    Article  PubMed  CAS  Google Scholar 

  69. Viles-Gonzalez JF, Fuster V, Halperin J, Calkins H, Reddy VY. Rhythm control for management of patients with atrial fibrillation: balancing the use of antiarrhythmic drugs and catheter ablation. Clin Cardiol. 2011;34:23–9.

    Article  PubMed  Google Scholar 

  70. Wilber DJ, Pappone C, Neuzil P, et al. Comparison of antiarrhythmic drug therapy and radiofrequency catheter ablation in patients with paroxysmal atrial fibrillation: a randomized controlled trial. JAMA. 2010;303:333–40.

    Article  PubMed  CAS  Google Scholar 

  71. Bhargava M, Di Biase L, Mohanty P, et al. Impact of type of atrial fibrillation and repeat catheter ablation on long-term freedom from atrial fibrillation: results from a multicenter study. Heart Rhythm. 2009;6:1403–12.

    Article  PubMed  Google Scholar 

  72. Reynolds MR, Walczak J, White SA, Cohen DJ, Wilber DJ. Improvements in symptoms and quality of life in patients with paroxysmal atrial fibrillation treated with radiofrequency catheter ablation versus antiarrhythmic drugs. Circ Cardiovasc Qual Outcomes. 2010;3:615–23.

    Article  PubMed  Google Scholar 

  73. Leong-Sit P, Roux JF, Zado E, et al. Antiarrhythmics after ablation of atrial fibrillation (5A Study): six-month follow-up study. Circ Arrhythm Electrophysiol. 2011;4:11–4.

    Article  PubMed  Google Scholar 

  74. Koyama T, Tada H, Sekiguchi Y, et al. Prevention of atrial fibrillation recurrence with corticosteroids after radiofrequency catheter ablation: a randomized controlled trial. J Am Coll Cardiol. 2010;56:1463–72.

    Article  PubMed  Google Scholar 

  75. Van Gelder IC, Groenveld HF, Crijns HJGM, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362:1363–73.

    Article  PubMed  Google Scholar 

  76. Stroke Risk in Atrial Fibrillation Working Group. Comparison of 12 risk stratification schemes to predict stroke in patients with nonvalvular atrial fibrillation. Stroke. 2008;39:1901–10.

    Article  Google Scholar 

  77. Lip GY, Frison L, Halperin JL, Lane DA. Identifying patients at high risk for stroke despite anticoagulation: a comparison of contemporary stroke risk stratification schemes in an anticoagulated atrial fibrillation cohort. Stroke. 2010;41:2731–8.

    Article  PubMed  CAS  Google Scholar 

  78. Lip GY, Nieuwlaat R, Pisters R, Lane DA, Crijns HJ. Refining clinical risk stratification for predicting stroke and thromboembolism in atrial fibrillation using a novel risk factor-based approach: the euro heart survey on atrial fibrillation. Chest. 2010;137:263–72.

    Article  PubMed  Google Scholar 

  79. Glotzer TV, Daoud EG, Wyse DG, et al. The relationship between daily atrial tachyarrhythmia burden from implantable device diagnostics and stroke risk: the TRENDS study. Circ Arrhythm Electrophysiol. 2009;2:474–80.

    Article  PubMed  Google Scholar 

  80. Glotzer TV, Hellkamp AS, Zimmerman J, et al. Atrial high rate episodes detected by pacemaker diagnostics predict death and stroke: report of the atrial diagnostics ancillary study of the MOde selection trial (MOST). Circulation. 2003;107:1614–9.

    Article  PubMed  Google Scholar 

  81. Botto GL, Padeletti L, Santini M, et al. Presence and duration of atrial fibrillation detected by continuous monitoring: crucial implications for the risk of thromboembolic events. J Cardiovasc Electrophysiol. 2009;20:241–8.

    Article  PubMed  Google Scholar 

  82. Boriani G, Botto GL, Padeletti L, et al. Improving stroke risk stratification using the CHADS2 and CHA2DS2-VASc risk scores in patients with paroxysmal atrial fibrillation by continuous arrhythmia burden monitoring. Stroke. 2011;42:1768–70.

    Article  PubMed  Google Scholar 

  83. Hohnloser SH, Capucci A, Fain E, et al. ASymptomatic atrial fibrillation and Stroke Evaluation in pacemaker patients and the atrial fibrillation Reduction atrial pacing Trial (ASSERT). Am Heart J. 2006;152:442–7.

    Article  PubMed  Google Scholar 

  84. Hart RG, Pearce LA, Aguilar MI. Meta-analysis: antithrombotic therapy to prevent stroke in patients who have nonvalvular atrial fibrillation. Ann Intern Med. 2007;146:857–67.

    Article  PubMed  Google Scholar 

  85. Zimetbaum PJ, Thosani A, Yu HT, et al. Are atrial fibrillation patients receiving warfarin in accordance with stroke risk? Am J Med. 2010;123:446–53.

    Article  PubMed  CAS  Google Scholar 

  86. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fibrillation. N Engl J Med. 2009;361:1139–51.

    Article  PubMed  CAS  Google Scholar 

  87. Connolly S, Pogue J, Hart R, et al. Clopidogrel plus aspirin versus oral anticoagulation for atrial fibrillation in the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE W): a randomised controlled trial. Lancet. 2006;367:1903–12.

    Article  PubMed  CAS  Google Scholar 

  88. Healey JS, Hart RG, Pogue J, et al. Risks and benefits of oral anticoagulation compared with clopidogrel plus aspirin in patients with atrial fibrillation according to stroke risk: the atrial fibrillation clopidogrel trial with irbesartan for prevention of vascular events (ACTIVE-W). Stroke. 2008;39:1482–6.

    Article  PubMed  CAS  Google Scholar 

  89. Mant J, Hobbs FD, Fletcher K, et al. Warfarin versus aspirin for stroke prevention in an elderly community population with atrial fibrillation (the Birmingham atrial fibrillation treatment of the aged study, BAFTA): a randomised controlled trial. Lancet. 2007;370:493–503.

    Article  PubMed  CAS  Google Scholar 

  90. Connolly SJ, Pogue J, Hart RG, et al. Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med. 2009;360:2066–78.

    Article  PubMed  Google Scholar 

  91. Rivaroxaban-once daily, oral, direct factor Xa inhibition compared with vitamin K antagonism for prevention of stroke and embolism trial in atrial fibrillation: rationale and design of the ROCKET AF study Investigator. Am Heart J. 2010;159:340–7.e1.

    Article  CAS  Google Scholar 

  92. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fibrillation. N Engl J Med. 2011;365(10):883–91.

    Article  PubMed  CAS  Google Scholar 

  93. Connolly SJ, Eikelboom J, Joyner C, et al. Apixaban in patients with atrial fibrillation. N Engl J Med. 2011;364:806–17.

    Article  PubMed  CAS  Google Scholar 

  94. Eikelboom JW, O’Donnell M, Yusuf S, et al. Rationale and design of AVERROES: apixaban versus acetylsalicylic acid to prevent stroke in atrial fibrillation patients who have failed or are unsuitable for vitamin K antagonist treatment. Am Heart J. 2010;159:348–53.e1.

    Article  PubMed  CAS  Google Scholar 

  95. Granger CB, Alexander JH, McMurray JJ, et al. Apixaban versus warfarin in patients with atrial fibrillation. N Engl J Med. 2011;365:981–92.

    Article  PubMed  CAS  Google Scholar 

  96. Stangier J. Clinical pharmacokinetics and pharmacodynamics of the oral direct thrombin inhibitor dabigatran etexilate. Clin Pharmacokinet. 2008;47:285–95.

    Article  PubMed  CAS  Google Scholar 

  97. Kubitza D, Becka M, Wensing G, Voith B, Zuehlsdorf M. Safety, pharmacodynamics, and pharmacokinetics of BAY 59-7939- an oral, direct factor Xa inhibitor–after multiple dosing in healthy male subjects. Eur J Clin Pharmacol. 2005;61:873–80.

    Article  PubMed  CAS  Google Scholar 

  98. Raghavan N, Frost CE, Yu Z, et al. Apixaban metabolism and pharmacokinetics after oral administration to humans. Drug Metab Dispos. 2009;37:74–81.

    Article  PubMed  CAS  Google Scholar 

  99. Yusuf S, Healey JS, Pogue J, et al. Irbesartan in patients with atrial fibrillation. N Engl J Med. 2011;364:928–38.

    Article  PubMed  CAS  Google Scholar 

  100. Pedersen OD, Bagger H, Kober L, Torp-Pedersen C. Trandolapril reduces the incidence of atrial fibrillation after acute myocardial infarction in patients with left ventricular dysfunction. Circulation. 1999;100:376–80.

    Article  PubMed  CAS  Google Scholar 

  101. Yin Y, Dalal D, Liu Z, et al. Prospective randomized study comparing amiodarone vs. amiodarone plus losartan vs. amiodarone plus perindopril for the prevention of atrial fibrillation recurrence in patients with lone paroxysmal atrial fibrillation. Eur Heart J. 2006;27:1841–6.

    Article  PubMed  CAS  Google Scholar 

  102. Disertori M, Lombardi F, Barlera S, et al. Clinical predictors of atrial fibrillation recurrence in the Gruppo Italiano per lo Studio della Sopravvivenza nell’Infarto miocardico-atrial fibrillation (GISSI-AF) trial. Am Heart J. 2010;159:857–63.

    Article  PubMed  Google Scholar 

  103. Adabag AS, Nelson DB, Bloomfield HE. Effects of statin therapy on preventing atrial fibrillation in coronary disease and heart failure. Am Heart J. 2007;154:1140–5.

    Article  PubMed  CAS  Google Scholar 

  104. Bhavnani SP, Coleman CI, White CM, et al. Association between statin therapy and reductions in atrial fibrillation or flutter and inappropriate shock therapy. Europace. 2008;10:854–9.

    Article  PubMed  Google Scholar 

  105. Dentali F, Gianni M, Squizzato A, et al. Use of statins and recurrence of atrial fibrillation after catheter ablation or electrical cardioversion; A systematic review and meta-analysis. Thromb Haemost. 2011;106:363–70.

    Article  PubMed  CAS  Google Scholar 

  106. Fauchier L, Pierre B, de Labriolle A, Grimard C, Zannad N, Babuty D. Antiarrhythmic effect of statin therapy and atrial fibrillation a meta-analysis of randomized controlled trials. J Am Coll Cardiol. 2008;51:828–35.

    Article  PubMed  CAS  Google Scholar 

  107. Liu T, Li L, Korantzopoulos P, Liu E, Li G. Statin use and development of atrial fibrillation: a systematic review and meta-analysis of randomized clinical trials and observational studies. Int J Cardiol. 2008;126:160–70.

    Article  PubMed  Google Scholar 

  108. Patel AA, White CM, Shah SA, Dale KM, Kluger J, Coleman CI. The relationship between statin use and atrial fibrillation. Curr Med Res Opin. 2007;23:1177–85.

    Article  PubMed  CAS  Google Scholar 

  109. Rahimi K, Emberson J, McGale P, et al. Effect of statins on atrial fibrillation: collaborative meta-analysis of published and unpublished evidence from randomised controlled trials. BMJ. 2011;342:d1250.

    Article  PubMed  CAS  Google Scholar 

  110. Kumar S, Sutherland F, Wheeler M, et al. Effects of chronic omega-3 polyunsaturated fatty acid supplementation on human atrial mechanical function after reversion of atrial arrhythmias to sinus rhythm: reversal of tachycardia-mediated atrial cardiomyopathy with fish oils. Heart Rhythm. 2011;8:643–9.

    Article  PubMed  Google Scholar 

  111. Fareh S, Benardeau A, Thibault B, Nattel S. The T-type Ca(2+) channel blocker mibefradil prevents the development of a substrate for atrial fibrillation by tachycardia-induced atrial remodeling in dogs. Circulation. 1999;100:2191–7.

    Article  PubMed  CAS  Google Scholar 

  112. Arya A, Silberbauer J, Teichman SL, Milner P, Sulke N, Camm AJ. A preliminary assessment of the effects of ATI-2042 in subjects with paroxysmal atrial fibrillation using implanted pacemaker methodology. Europace. 2009;11:458–64.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Cardiology Division, Medicine Department, Beth Israel Deaconess Medical Center, 185 Pilgrim Road, Baker 4, Boston, MA, 02215, USA

    Patricia Tung MD & Peter J. Zimetbaum MD

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  1. Patricia Tung MD
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  2. Peter J. Zimetbaum MD
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Correspondence to Peter J. Zimetbaum MD .

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  1. , Department of Internal Medicine, UMDNJ-RWJ Medical School, Robert Wood Johnson Pl. 1, New Brunswick, 08903-0019, New Jersey, USA

    Ihor Gussak

  2. , Gordon K. Moe Scholar, Masonic Medical Research Laboratory, Bleecker Street, Utica, 13501-1787, New York, USA

    Charles Antzelevitch

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Tung, P., Zimetbaum, P.J. (2013). Non-surgical Treatment and Prevention of Atrial Fibrillation. In: Gussak, I., Antzelevitch, C. (eds) Electrical Diseases of the Heart. Springer, London. https://doi.org/10.1007/978-1-4471-4978-1_35

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  • DOI: https://doi.org/10.1007/978-1-4471-4978-1_35

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