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SF | CARDIOLOGY
March 2021 | Vol. 21 No. 3
This article was independently sourced by Specialist Forum.
Rhythm control for ALL patients with early AFib
www.medicalacademic.co.za
Please note that th i s is a shorte ned ve rs of the a rticle. T ion h article is avail e full a bl our onl ine pla e on Systematic and early initiation of rhythm control therapy should be tform Medica part of the management of all patients with early atrial fibrillation (AFib) l Academ ic. who are at risk of concomitant cardiovascular diseases (CVDs).
T
his should be done in combination with oral anticoagulation and rate control, as well as the treatment of underlying CVDs. The risk of CV complications is increased during the first year after AFib is diagnosed. This is according to Prof Paulus Kirchhof, director of the department of cardiology at the University Heart and Vascular Center Hamburg (Germany), and professor of CV medicine at the Institute of CV Sciences at the University of Birmingham (United Kingdom). Prof Kirchhof is the lead author of the landmark Early Treatment of AFib for Stroke Prevention Trial (EAST-AFNET 4). He was one of the keynote speakers at the recent virtual Cardiac Arrhythmia Society of Southern Africa 2021 symposium. He provided a brief overview
of the findings of the trial, which was stopped for efficacy at the third interim analysis after a median of 5.1 years of follow-up per patient.
Take-home messages Early initiation of improved CV outcomes in patient with early AFib and CV conditions without affecting nights spent in hospital As expected, the early rhythm control strategy was associated with more adverse events related to rhythm control therapy but the overall safety of both treatment strategies was comparable These results have the potential to inform the future use of rhythm control therapy, further improving the care of patients with early AFib
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Systematic and early initiation of rhythm control therapy should be part of the management in all patients with recently diagnosed AFib and concomitant CV conditions in addition to oral anticoagulation, rate control and therapy of concomitant CV conditions. Whenever you ask yourself if you should initiate anticoagulation therapy in a patient with AFib, you should from now on ask yourself if you need to initiate rhythm control therapy. Prof Kirchhof concluded that the cardiology community needs to relearn the art of prescribing anti-arrhythmic drugs, that has somehow disappeared from medical training curricula. That specialist knowledge needs to be reappreciated and reacquired, he emphasised. SF
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Recommended as a treatment option for restoring and maintaining Sinus Rhythm (SR) in patients with Paroxysmal Atrial Fibrillation (PAF) and minimal or no structural heart disease1 European Society of Cardiology (ESC) Guidelines 2020
Significantly reduces the number of AF recurrences in paroxysmal AF and the symptoms associated with AF 2
AF = Atrial Fibrillation References: 1. Gerhard Hindricks G, Potpara T, Dagres N, et al. 2020 ESC Guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). European Heart Journal 2020;00:1-126. 2. Aliot E, et al. Twenty-five years in the making: flecainide is safe and effective for the management of atrial fibrillation. Europace 2011;13:161-173. Scheduling status: Proprietary name and dosage form: Tambocor Tablets. Composition: Each tablet contains flecainide acetate 100 mg. Reg. No.: S/6.2/17. Scheduling status: Proprietary name Proprietary name and dosage and dosage form: Tambocor CR 100 Capsules. Composition: Each controlled release capsule contains flecainide acetate 100 mg. Reg. No.: 37/6.2/0199. Scheduling status: form: Tambocor CR 200 Capsules. Composition: Each controlled release capsule contains flecainide acetate 200 mg. Reg. No.: 37/6.2/0201. Scheduling status: Proprietary name and dosage form: Tambocor Injection. Composition: Each ampoule contains 15 ml of solution of flecainide acetate 10 mg/ml, for intravenous use only. Reg. No.: S/6.2/16. Name and business address of the holder of the certificate of registration: iNova Pharmaceuticals (Pty) Ltd,. Co. Reg. No. 1952/001640/07, 15e Riley Road, Bedfordview. Tel. No.: 011 087 0000. www.inovapharma.co.za. For full prescribing information, refer to the package insert as approved by the SAHPRA (South African Health Products Regulatory Authority). Further information is available on request from iNova Pharmaceuticals. 15255L. IN4081/21.
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