Guidelines for the clinical management of atrial fibrillation: a practical perspective.

Details

Ressource 1Download: 15243851.pdf (313.85 [Ko])
State: Public
Version: Final published version
Serval ID
serval:BIB_18D67A5FE6A9
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Guidelines for the clinical management of atrial fibrillation: a practical perspective.
Journal
Swiss medical weekly
Author(s)
Fumeaux T., Cornuz J., Polikar R., Blanc E., Junod A., Kappenberger L., Nicod P., Schläpfer J.
ISSN
1424-7860 (Print)
ISSN-L
0036-7672
Publication state
Published
Issued date
01/05/2004
Peer-reviewed
Oui
Volume
134
Number
17-18
Pages
235-247
Language
english
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Abstract
Since the management of atrial fibrillation may be difficult in the individual patient, our purpose was to develop simple clinical recommendations to help the general internist manage this common clinical problem.
Systematic review of the literature with evaluation of data-related evidence and framing of graded recommendations.
Atrial fibrillation affects some 1% of the population in Western countries and is linked to a significant increase in morbidity and mortality. The management of atrial fibrillation requires individualised evaluation of the risks and benefits of therapeutic modalities, relying whenever possible on simple and validated tools. The two main points requiring a decision in clinical management are 1) whether or not to implement thromboembolic prevention therapy, and 2) whether preference should be given to a "rate control" or "rhythm control" strategy. Thromboembolic prophylaxis should be prescribed after individualised risk assessment: for patients at risk, oral anticoagulation with warfarin decreases the rate of embolic complications by 60% and aspirin by 20%, at the expense of an increased incidence of haemorrhagic complications. "Rate control" and "rhythm control" strategies are probably equivalent, and the choice should also be made on an individualised basis. To assist the physician in making his choices for the care of an atrial fibrillation patient we propose specific tables and algorithms, with graded recommendations.
On the evidence of data from the literature we propose simple algorithms and tables for the clinical management of atrial fibrillation in the individual patient.

Keywords
Algorithms, Anti-Arrhythmia Agents/therapeutic use, Anticoagulants/therapeutic use, Atrial Fibrillation/diagnosis, Atrial Fibrillation/drug therapy, Atrial Fibrillation/physiopathology, Atrial Fibrillation/therapy, Electric Countershock, Humans, Practice Guidelines as Topic
Pubmed
Web of science
Create date
05/03/2008 15:56
Last modification date
20/08/2019 12:49
Usage data