Atrial Fibrillation

(rate control)
2014 ACC/AHA
1. beta-blocker non-DHP CCB
paroxysmal, persistent,
permanent AF
2. non-DHP CCB decompensated heart
failure negative
inotropic
3. dronedarone
permanent AF stroke,
myocardia infraction, systemic embolism

4. amiodarone
AF

(rate control)
2014 ACC/AHA

(restore and rhythm control) 2014
ACC/AHA

rhythm control
rate control stroke

rate control
 anti-arrhythmia

rate control
rhythm
control sinus rhythm
rhythm

control AF rate
control

electrical cardioversion

1. electrical cardioversion
AF ,

2. electrical cardioversion rhythm
control sinus rhythm
3. electrical cardioversion
3.1. electrode anterolateral
anteroposterior
3.2. biphasic wave form
electrode
3.3. anti-arrhythmia electrical cardioversion
4. electrical cardioversion digitalis
hypokalemia

cardioversion
1. flecainide*, dofetilide, propafenone* ibutilide



ibutilide dofetilide
QT prolong
torsarde de pointes
(*)
2. amiodarone
3. pill in the pocket flecainide
propafenone beta-blocker non-DHP CCB
AF

(restore and rhythm control) 2014
ACC/AHA
 thromboembolism
 Atrial fibrillation ( maintenance of
sinus rhythm)
1.
anti-arrhythmia

AF
2. anti-arrhythmia

1. flecainide, propafenone


2. flecainide, propafenone, sotalol, dofetilide


(>1.5 cm)
3. sotalol, dofetilide

torsades de
pointes
4. flecainide, propafenone AV node
beta-blocker, non-DHP CCB atrial flutter

1:1 AV conduction
5. dronedarone
NYHA class III
IV
4

6. anti-arrhythmia


permanent AF dronedarone


stroke, myocardia infraction, systemic embolism

Atrial fibrillation (
maintenance of sinus rhythm) 2014 ACC/AHA
 catheter ablation
1. catheter ablation paroxysmal AF

anti-arrhythmia 1
rhythm-control
AF


2. catheter ablation persistent AF
anti-arrhythmia 1
rhythm-control
AF (Class IIa)
3. catheter ablation
paroxysmal AF anti-
arrhythmia

(Class IIa)
4. catheter ablation persistent AF
12 anti-arrhythmia
1 rhythm-control
AF (Class IIb)
5. catheter ablation
persistent AF

anti-arrhythmia
rhythm-control
AF

(Class IIb)