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European Heart Journal 1994 15(Supplement A):17-21; doi:10.1093/eurheartj/15.suppl_A.17
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Benefits and Risks of Antiarrhythmic Drug Therapy after DC Electrical Cardioversion of Atrial Fibrillation or Flutter

H. J. G. M. Crijns, I. C. van Gelder and K. I Lie

Department of Cardiology, Thoraxcenter, University Hospital Groningen The Netherlands

Correspondence: Harry J. G. M. Crijns, MD, Department of Cardiology, Thoraxcenter, University Hospital Groningen, P.O. Box 30001, 9700 RB Groningen, The Netherlands

Electrical cardioversion is the method of choice to restore sinus rhythm in patients with chronic atrial fibrillation. After cardioversion, long-term maintenance of sinus rhythm is troublesome since many patients relapse. In addition, haemodynamic complications associated with recurrence and hazards of prophylactic antiarrhythmic drug therapy are among the problems threatening these patients. Several new antiarrhythmics have become available but their safety remains to be established. Advantages of prophylactic antiarrhythmic treatment must be carefully weighed against the hazards As a consequence, nonpharmacological modalities like serial electrical cardioversions (no drugs) and His bundle ablation may become important treatment modalities The present report summarizes current antiarrhythmic strategies, focusing primarily on feasibility of prophylactic treatment and on early and late proarrhythmia.

Key Words: Atrial fibrillation • electrical cardioversion • antiarrhythmic drugs


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