[Pharmacological therapy of XXXX and atrial flutter].

@entity1 @entity2643 @entity712 @entity101 @entity591 @entity955 @entity299 @entity453
BACKGROUND: Despite the increasing availability of nonpharmacological treatment options for @entity955 , drug therapy targeted at restoration and maintenance of sinus rhythm, or aimed at symptomatic ventricular rate control remains the mainstay of therapy for the majority of @entity1 . METHOD: Available data suggest that these two treatment approaches yield similar responder rates with regard to symptomatic improvement. RESULTS: Detailed results from major prospective studies investigating the prognostic effects of different @entity955 treatment modalities are expected to become available soon. At present, however, the choice of the primary treatment strategy, i.e. rate control or rhythm control, still remains upon the clinical decision and expertise of the treating physician. Cardioversion by means of external biphasic shock delivery has shown to effectively convert @entity955 to sinus rhythm in more than 90% of @entity1 . Pharmacological cardioversion, in contrast, has a far lower success rate and may be followed by severe complications mandating in-hospital administration with the majority of drug regimens. For the maintenance of sinus rhythm, the proarrhythmic side effects of Class I antiarrhythmic drugs currently limit their use to those @entity1 without any structural @entity299 . Clinical investigation of newer "pure" Class III drugs have shown to excite considerable prolongation of ventricular repolarization duration resulting in a significant risk for torsade-de-pointes @entity591 . Betablockers are beneficial in many clinical situations associated with the occurrence of @entity955 , such as @entity712 , @entity101 and @entity453 . These substances, however, do not seem to improve cardioversion rates and their effect in maintaining sinus rhythm is only moderate. @entity1 with structural @entity299 in whom maintenance of sinus rhythm is strongly desired, therefore, are left to @entity2643 therapy. The cardiac safety profile as well as the proven effectiveness are unsurpassed by any other available drug at present. This paper reviews major studies published during the last decade implementing recent guidelines regarding pharmacological rate control, cardioversion and maintenance of sinus rhythm and the approach towards @entity1 suffering from @entity955 .
