Figures issues des Recommandations ESC 2012 sur FA
Figure 1. Choice of antiarrhythmic drug according to underlying pathology.
Key points (p. 2741)
dagger; Rhythm-control therapy, whether by antiarrhythmic drugs or by catheter ablation, is indicated to relieve symptoms associated with AF.
dagger; Antiarrhythmic drugs should not be used for rate control in patients with permanent AF, unless appropriate rate control agents fail.
dagger; In selected patients, limiting antiarrhythmic drug therapy to four weeks after cardioversion may help to improve safety.
dagger; In a given patient, the choice of an antiarrhythmic drug should be driven by the perceived safety of the drug. This is more important than perceived efficacy.
dagger; Dronedarone is recommended in patients with recurrent AF as a moderately effective antiarrhythmic agent for the maintenance of sinus rhythm (Classe I A). Dronedarone is appropriate for maintaining sinus rhythm inpatients with paroxysmal or persistent AF. Best in case of « Minimal or no structural heart disease » ou « moderate LVH », not in permanent AF.
dagger; Dronedarone should not be given to patients with moderate or severe heart failure, and should be avoided in patients with less-severe heart failure, if appropriate alternatives exist.
dagger; Catheter ablation of atrial fibrillation.