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Update on the Management of Atrial Fibrillation: Anticoagulation and Medical Therapy

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Abstract

2010 saw the introduction of dabigatran (Pradaxa; Boehringer Ingelheim Pharmaceuticals, Ridgefield, CT), following US Food and Drug Administration approval, into daily clinical practice in the United States as an alternative to Coumadin (Bristol-Myers-Squibb, New York, NY) therapy. Dronedarone (Multaq; Sanofi-Aventis, Bridgewater, NJ), originally approved for use in the United States in 2009, has seen further widespread deployment in contemporary clinical practice. Intravenous vernakalant (Cardiome Pharm, Vancouver, B.C., Canada; Merck & Co., Whitehouse Station, NJ) is being considered for approval in the United States and may serve as an alternative to current agents for safe and efficacious acute conversion from atrial fibrillation. We focus primarily on new information concerning these and other antiarrhythmic drug and anticoagulation therapies. We provide brief updates of recently published articles along with our perspective on how they will likely alter clinical practice now and in the future.

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Abbreviations

ACT:

Atrial Arrhythmia Conversion Trial

AF-CHF:

Atrial Fibrillation and Congestive Heart Failure

AFFIRM:

Atrial Fibrillation Follow-up Investigation of Rhythm Management

ANDROMEDA:

Antiarrhythmic Trial with Dronedarone in Moderate to Severe CHF Evaluating Morbidity Decrease

ARISTOTLE:

Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation

ATHENA:

A Trial with Dronedarone to Prevent Hospitalization or Death in Patients with Atrial Fibrillation

AVERROES:

Apixaban Versus Acetylsalicylic Acid to Prevent Strokes

AVRO:

A Phase III Superiority Study of Vernakalant Versus Amiodarone in Subjects with Recent Onset Atrial Fibrillation

DIONYSOS:

Efficacy and Safety of Dronedarone Versus Amiodarone for the Maintenance of Sinus Rhythm in Patients with Persistent Atrial Fibrillation

ENGAGE AF-TIMI 48:

Effective Anticoagulation with Factor Xa Next Generation in Atrial Fibrillation

RACE:

Rate Control Versus Electrical Cardioversion for Persistent Atrial Fibrillation

RACE II:

Rate Control Efficacy in Permanent Atrial Fibrillation

RE-LY:

Randomized Evaluation of Long-Term Anticoagulation Therapy

ROCKET AF:

Rivaroxaban Once Daily Oral Direct Factor Xa Inhibition Compared with Vitamin K Antagonism for Prevention of Stroke and Embolism Trial in Atrial Fibrillation

VALIANT:

Valsartan in Acute Myocardial Infarction Trial

References

Papers of particular interest, published recently, have been highlighted as: • Of importance

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Disclosure

Conflicts of interest: S.H. Lim: none; H. Calkins: has been a consultant for Sanofi-Aventis; S.K. Sinha: none.

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Authors and Affiliations

  1. Division of Cardiology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA

    Shueh Hao Lim, Hugh Calkins & Sunil K. Sinha

  2. The Johns Hopkins Hospital, Carnegie 530, 600 North Wolfe Street, Baltimore, MD, 21287, USA

    Sunil K. Sinha

Authors
  1. Shueh Hao Lim
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  2. Hugh Calkins
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  3. Sunil K. Sinha
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Correspondence to Sunil K. Sinha.

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Lim, S.H., Calkins, H. & Sinha, S.K. Update on the Management of Atrial Fibrillation: Anticoagulation and Medical Therapy. Curr Cardiol Rep 13, 387–393 (2011). https://doi.org/10.1007/s11886-011-0199-9

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  • DOI: https://doi.org/10.1007/s11886-011-0199-9

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