Update on the Management of Atrial Fibrillation: Anticoagulation and Medical Therapy
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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.
KeywordsAtrial fibrillation Dabigatran Dronedarone Vernakalant Anticoagulation Medical therapy
Clinical Trial Acronyms
Atrial Arrhythmia Conversion Trial
Atrial Fibrillation and Congestive Heart Failure
Atrial Fibrillation Follow-up Investigation of Rhythm Management
Antiarrhythmic Trial with Dronedarone in Moderate to Severe CHF Evaluating Morbidity Decrease
Apixaban for Reduction in Stroke and Other Thromboembolic Events in Atrial Fibrillation
A Trial with Dronedarone to Prevent Hospitalization or Death in Patients with Atrial Fibrillation
Apixaban Versus Acetylsalicylic Acid to Prevent Strokes
A Phase III Superiority Study of Vernakalant Versus Amiodarone in Subjects with Recent Onset Atrial Fibrillation
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
Rate Control Versus Electrical Cardioversion for Persistent Atrial Fibrillation
- RACE II
Rate Control Efficacy in Permanent Atrial Fibrillation
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
Valsartan in Acute Myocardial Infarction Trial
Papers of particular interest, published recently, have been highlighted as: • Of importance
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