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Choice of prophylactic medication for atrial fibrillation

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Choice of prophylactic medication for atrial fibrillation

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15.09.2017 • Sonuncu dəyişiklik 15.09.2017
Finnish Current Care Guidelines / Working group on atrial fibrillation

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Choice of prophylactic medication for atrial fibrillation. The choice of prophylactic medication is essentially affected by other (cardiac) diseases of the patient. In outpatient care, the first-line drug is usually a beta blocker. Of the actual antiarrhythmic agents, Class IC drugs (flecainide) are the first-line drugs in lone atrial fibrillation. Quinidine and disopyramide (special regulatory restrictions may apply) are particularly suitable for the prevention of vagal AF. Structural heart disease is a contraindication for the use of Class I antiarrhythmic agents. The use of sotalol is restricted by the risk of torsades de pointes ventricular tachycardia. Amiodarone and dronedarone cause numerous extra-cardiac adverse effects which restricts their use. ACE inhibitors and angiotensin II receptor blockers (ARBs) appear to prevent the occurrence of AF in patients with heart failure and hypertension.