Fibrillation atriale 8b. contrôle rythme

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.