Antiarrhythmic Treatment in Atrial Fibrillation

Seema Ledan, PharmD

Disclosures

US Pharmacist. 2020;45(2):24-27. 

In This Article

Abstract and Introduction

Abstract

Atrial fibrillation is one of the most common forms of cardiac disturbances, diagnosed in an estimated 2.7 million to 6.1 million people in the United States, with prevalence increasing with age. Based on the individual's symptoms, medical treatment is available to help control the heart's rate and rhythm and reduce the risk of clots or strokes. Successful strategies to restore and maintain sinus rhythm have been shown to improve symptoms and quality of life. However, selection of antiarrhythmic drugs should be based on underlying heart disease and comorbidities, due to drug interactions, adverse reaction profile, and monitoring requirements with antiarrhythmic agents. Pharmacists can play a vital role in therapy selection and recommendations for continuation of therapy.

Introduction

Atrial fibrillation (AF) is one of the most common forms of cardiac disturbances, diagnosed in an estimated 2.7 million to 6.1 million people in the United States, with prevalence increasing with age.[1,2] AF is an arrhythmia or irregular heartbeat with uncoordinated atrial activation and ineffective atrial contraction, leading to inadequate blood flow into the ventricles.[1,2] Symptoms may include irregular heartbeat, heart palpitations, extreme fatigue, shortness of breath, and chest pain.[2] AF is associated with an increased risk of stroke, heart failure, dementia, hospitalization, and death.[1] As the death rate has risen over the past two decades, the cost of AF in the U.S. has also increased, with annual medical costs more than $8,000 per patient higher when compared with those without AF.[1–5]

A multipronged approach is needed for the management of AF. Based on the individual's symptoms, medical treatment is available to help control the heart's rate (rate control) and rhythm (rhythm control) and to reduce the risk of clots or stroke (anticoagulants).[1,2]

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