New possibilities of antiarrhythmic therapy of atrial fibrillation: A review

Abstract

Atrial fibrillation (AF) is the most common heart rhythm disorder. According to current recommendations, the treatment of AF includes 3 main directions: "A" – the appointment of anticoagulant therapy with an increased risk of thromboembolic complications, "B" – control of arrhythmia symptoms, choice of a strategy for rhythm control or control of ventricular contractions, "C" – treatment of concomitant diseases and correction of risk factors. The rhythm control strategy includes performing cardioversion, prescribing long-term antiarrhythmic therapy, or performing radiofrequency catheter ablation. According to the latest recommendations of 2020, antiarrhythmic drugs of IC and III classes are currently used for pharmacological cardioversion of AF and long-term retention of sinus rhythm. The choice of a specific antiarrhythmic drug is based on its safety and effectiveness. â-Blockers, non-dihydropyridine calcium channel blockers and digoxin are used to control CHS. The results of modern research have significantly expanded our understanding of the molecular mechanisms underlying various forms of AF. Currently, the search for new drugs is actively underway that will allow preventing the development of AF and its progression at the molecular level.

Keywords

• atrial fibrillation
• antiarrhythmic therapy
• treatment strategy