Antiarrhythmic therapy in the treatment of atrial fibrillation: yesterday, today, tomorrow
https://doi.org/10.15829/1728-8800-2019-3-81-87
Abstract
Atrial fibrillation (AF) is the most common heart rhythm disorder encountered in clinical practice. Each year, the number of patients with AF significantly increases. It is associated with an increase of life expectancy and frequency of cardiovascular pathologies. Treatment of AF remains one of the most difficult tasks of modern cardiology. Currently, only a few antiarrhythmic drugs are available for use in Russia. More and more new attempts are being made to create a universal antiarrhythmic drug with a high level of anti-relapsing efficacy and adverse effects. The accumulated information suggests that the tactics of management of patients with arrhythmias will be intended to improving the new surgical and interventional treatment methods with use of anticoagulants and antiarrhythmic drugs. The multidisciplinary team of specialists on AF treatment should include an expert (cardiologist) in antiarrhythmic drug therapy, an interventional electrophysiologist, and a cardiac surgeon — master the technology of interventional or surgical ablation. Effective interaction of specialists of various levels will improve the results of rhythm control and prevention of complications in patients with AF.
About the Authors
V. I. Podzolkov
I. M. Sechenov First Moscow State Medical University
Russian Federation
Moscow
Russian Federation
Moscow
A. I. Tarzimanova
I. M. Sechenov First Moscow State Medical University
Russian Federation
Moscow
Russian Federation
Moscow
References
1. January CT, Wann LS, Calkins H, et al. 2019 AHA/ACC/HRS Focused Update of the 2014 AHA/ACC/HRS Guideline for the Management of Patients With Atrial Fibrillation. Heart Rhythm. 2019;Jan:1-64. doi:10.1016/j.hrthm.2019.01.024.
2. Darby A. Management of atrial fibrillation in patients with structural heart disease. Circulation. 2012;125:945-57. doi:10.1161/CIRCULATIONAHA.111.019935.
3. Kirchhof P, Lip GY, Van Geider IC, et al. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options — a report from the 3rd Atrial Fibrillation Competence NETwork. Europace. 2012;14:8-27. doi:10.1093/europace/eur241. Epub 2011 Jul 26.
4. Loukianov MM, Boytsov SA, Yakushin SS, et al. Outpatient registry of cardiovascular disease (RECVASA): prospective follow-up data, ectimation of risks and outcomes in patients with atrial fibrillation. Rational Pharmacotherapy in Cardiology. 2014;10(5):47080. (In Russ.) doi:10.20996/1819-6446-2014-10-5-470-480.
5. Bonhorst D, Mendes M, Adragao P, et al. Prevalence of atrial fibrillation in the Portuguese population aged 40 and over: the FAMA study. Rev Port Cardiol. 2010;29(3):331-50.
6. Schnabel RB, Yin X, Gona P, et al. 50 year trends in atrial fibrillation prevalence, incidence, risk factors, and mortality in the Framingham Heart Study: a cohort study. Lancet. 2015;386:154-62. doi:10.1016/S0140-6736(14)61774-8. Epub 2015 May 7.
7. Apostolakis S, Lane DA, Buller H, et al. Comparison of the CHADS2, CHA2DS2VASc and HAS-BLED scores for the prediction of clinically relevant bleeding in anticoagulated patients with atrial fibrillation: The AMADEUS trial. Thromb Haemost. 2013;110:1074-9. doi:10.1160/TH13-07-0552. Epub 2013 Sep 19.
8. Kirchhof P, Benussi S, Kotecha D, et al. ESC Scientific Document Group. 2016 ESC guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J. 2016;37:2893-962. doi:10.1093/eurheartj/ehw210. Epub 2016 Aug 27.
9. Pistoia F, Sacco S, Tiseo C, et al. The Epidemiology of Atrial Fibrillation and Stroke. Cardiol Clin. 2016;34(2):255-68. doi:10.1016/j.ccl.2015.12.002. Epub 2016.
10. Go AS, Mozaffarian D, Roger VL, et al. American Heart Association Statistics Committee and Stroke Statistics Subcommittee. Heart disease and stroke statistics 2014 update: a report from the American Heart Association. Circulation. 2014;129(3):399-410. doi:10.1161/01.cir.0000442015.53336.12.
11. Friberg L, Rosenqvist M, Lip GY. Evaluation of risk stratification schemes for ischaemic stroke and bleeding in 182 678 patients ith atrial fibrillation: the Swedish Atrial Fibrillation cohort study. Eur Heart. 2012;33:1500-10. doi:10.1093/eurheartj/ehr488. Epub 2012 Jan 13.
12. 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(12):2731-8. doi:10.1161/STROKEAHA.110.590257. Epub 2010 Oct 21.
13. Graifer IV, Reshet’ko OV, Furman NV. Pharmacoepidemiologycal analysis of the treatment of paroxysmal and persistent atrial fibrillation in every day clinical practice. Rational Pharmacotherapy in Cardiology. 2011;7(2):177-84. (In Russ.) doi:10.20996/1819-6446-2011-7-2-177-184.
14. Sculpher M. Subgroups and Heterogeneity in Cost-Effectiveness Analysis. Pharmacoeconomics. 2008;26(9):799-806.
15. Camm AJ, Breithardt G, Crijns H. Real-life observations of clinical outcomes with rhythmand rate-control therapies for atrial fibrillation RECORD AF. JACC. 2011;58:493-501. doi:10.1016/j.jacc.2011.03.034.
16. De Vos CB, Limantoro I, Pisters R. The mechanical fibrillation pattern of the atrial myocardium is associated with acute and long-term success of electrical cardioversion in patients with persistent atrial fibrillation. Heart Rhythm. 2014;11(9):1514-21. doi:10.1016/j.hrthm.2014.04.029. Epub 2014 Apr 21.
17. ESC guidelines for the treatment of patients with atrial fibrillation, developed in conjunction with EACTS. Russian Journal of Cardiology. 2017;22(7):7-86. (In Russ.)
18. Stoschitzky K, Stoschitzky G, Lercher P, et al. Propafenone shows class Ic and class II antiarrhythmic effects. Europace. 2016;18(4):568-71. doi:10.1093/europace/euv195. Epub 2015 Jun 7.
19. Khan IA. Single oral loading dose of propafenone for pharmacological cardioversion of recent-onset atrial fibrillation. JACC. 2001;37(2):542-7.
20. Heldal M, Atar D. Pharmacological conversion of recent‐onset atrial fibrillation: a systematic review. Scand Cardiovasc J. 2013;47(Suppl.):2-10. doi:10.3109/14017431.2012.740572. Epub 2012 Nov 13.
21. Podzolkov VI, Tarzimanovа AI. Propafenone in the treatment of heart rhythm disorders. Kardiologiia. 2012;5:70-3. (In Russ.)
22. Kochiadakis GE, Igoumenidis NE, Hamilos ME, et al. A comparative study of the efficacy and safety of procainamide versus propafenone versus amiodarone for the conversion of recent‐onset atrial fibrillation. Am J Cardiol. 2007;99:1721-5. doi:10.1016/j.amjcard.2007.01.059.
23. Andrade JG, MacGillivray J, Macle L, et al. Clinical effectiveness of a systematic “pillinthe-pocket” approach for the management of paroxysmal atrial fibrillation. Heart Rhythm. 2018;15(1):9-16. doi:10.1016/j.hrthm.2017.10.002.
24. Mironov NYu, Golitsyn SP, Sokolov SF, et al. Electrophysiological and antiarrhythmic effects of a new domestic anti-arrhythmic drug class III of nipheridel. Message I: electrophysiological effects of nipheridel in patients with paroxysmal supraventricular tachycardia. Vestnic of Arrhythmology. 2012;70:5-13. (In Russ.)
25. Mikov EB, Juricev YA, Mironov NYu, et al. Refralon (nipheridel) is a new antiarrhythmic class III drug for pharmacological cardioversion of persistent atrial fibrillation and atrial flutter. Ter Arkh. 2015;1:38-48. (In Russ.) doi:10.17116/terarkh201587138-48.
26. Sullivan SD. Interventions for the treatment of atrial fibrillation: A systematic literature review and meta-analysis. Int J Cardiol. 2012;31:345-9. doi: 10.1016/j.ijcard.2012.03.070. Epub 2012 Apr 1.
27. Lafuente-Lafuente C. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fibrillation. Cochrane Database Syst Rev. 2012;5:5049-51. doi:10.1002/14651858.CD005049.pub3.
28. Haverkamp W, Breithardt G, Camm AJ, et al. The potential for QT prolongation and proarrhythmia by non-antiarrhythmic drugs: clinical and regulatory implications. Report on a policy conference of the European Society of Cardiology. Eur Heart J. 2000;21:1216-31. doi:10.1053/euhj.2000.2249.
29. Miller ON, Starichcov SA, Pozdnyakov YuM, et al. Efficacy and safety of propafenone (propanorm) and amiodarone (cordarone) in atrial fibrillation patients with arterial hypertension, coronary heart disease and chronic heart failure with preserved systolic function of the left ventricle. Russian Journal of Cardiology. 2010;(4):56-72. (In Russ.)
30. Singh BN, Singh SN, Reda DJ, et al. Amiodarone versus sotalol for atrial fibrillation. N Engl J Med. 2005;352:1861-72.
31. Gwag HB, Chun KJ, Hwang JK, et al. Which antiarrhythmic drug to choose after electrical cardioversion: A study on non-valvular atrial fibrillation patients. PLoS One. 2018;13(5):e0197352. doi:10.1371/journal.pone.0197352.
32. Nedostup AV, Blagova OV. Etatsizin: a place in the treatment of arrhythmias. Cardiology and cardiovascular surgery. 2009;4:62-8. (In Russ.)
33. Parvez B, Vaglio J, Rowan S, et al. Symptomatic Responseto Antiarrhythmic Drug Therapy Is Modulated by a Common Single Nucleotide Polymorphismin Atrial Fibrillation. JACC. 2012;60(6):539-45. doi:10.1016/j.jacc.2012.01.070.
34. Lunshof JE, and Gurwitz D. Pharmacogenomic testing: knowing more, doing better. Clin Pharmacol Ther. 2012;91:387-9. doi:10.1038/clpt.2011.339.
35. Benjamin EJ, Rice KM, Arking DE, et al. Variants in ZFHX3 are associated with atrial fibrillation in individuals of European ancestry. Nat Genet. 2009;41:879-81. doi:10.1038/ng.416.
36. Ellinor PT, Lunetta KL, Glazer NL, et al. Common variants in KCNN3 are associated with lone atrial fibrillation. Nat Genet. 2010;42:240-4. doi:10.1038/ng.537.
37. Burashnikov A Barajas-Martinez H. Atrial-selective prolongation of refractory period with AVE0118 is due principally to inhibition of sodium channel activity. J Cardiovasc Pharmacol. 2012;59:539-46. doi:10.1097/FJC.0b013e31824e1b93.
38. Ford J, Milnes J, Wettwer E. Нuman electrophysiological and pharmacological properties of XEN-D0101: a novel atrial-selective Kv1.5/IKur inhibitor. J Cardiovasc Pharmacol. 2013;61:408-15. doi:10.1097/FJC.0b013e31828780eb.
39. Loose S, Mueller J, Wettwer E. Effects of IKur blocker MK-0448 on human right atrial action potentials from patients in sinus rhythm and in permanent atrial fibrillation. Front Pharmacol. 2014;5:26. doi:10.3389/fphar.2014.00026. eCollection 2014.
40. Tarasov AV, Davtyan KV, Shatakhtsyan VS. Effectiveness of antiarrhythmic therapy for different types of atrial tachyarrhythmias relapses in the early postoperative period of catheter isolation of the mouths of pulmonary veins. Cardiology and cardiovascular surgery. 2017;2:70-7. (In Russ.) doi:10.17116/kardio201710270-77.
Review
For citations:
Podzolkov V.I., Tarzimanova A.I. Antiarrhythmic therapy in the treatment of atrial fibrillation: yesterday, today, tomorrow. Cardiovascular Therapy and Prevention. 2019;18(3):81-87. (In Russ.) https://doi.org/10.15829/1728-8800-2019-3-81-87
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