Similar outcomes for atrrial fibrillationi patients with congestive heart failure

ORLANDO, FLA. Duke University Medical Center cardiologists have shown that patients with an abnormal heart rhythm known as atrial fibrillation, and who also have congestive heart failure (CHF), have similar mortality rates when treated with drugs that control the heart's rhythm compared to treatment with drugs that control the heart's rate.

The findings, which support the results of an earlier study, are important because the use of drugs to restore the heart's normal rhythm has been on the increase over the past decade, despite the fact these drugs have more negative side effects than those controlling the heart's rate, the researchers said. They added that further prospective studies should be conducted to weigh the mortality and quality-of-life issues for each of the two strategies for patients with atrial fibrillation and CHF.

Duke cardiologist Sana Al-Khatib, M.D., presented the results of the Duke analysis today (Nov. 10, 2003) at the 76th annual scientific sessions of the American Heart Association.

In atrial fibrillation the upper chambers of the heart, known as the atria, contract extremely rapidly. This causes the pumping chambers of the heart, the ventricles, to pump erratically and inefficiently. The other condition, CHF, is marked by the inability of the heart muscle to pump enough oxygen and nutrients to the body's tissues. Once diagnosed with CHF, about 50 percent of patients die within five years.

For patients with atrial fibrillation, physicians can control the rate of ventricular contraction with drugs such as digoxin or beta-blockers. In contrast, the rhythm strategy tries to correct underlying electrical abnormalities either by electric shock (electrical cardioversion) and/or with drugs (pharmacologic cardioversion) such as amiodarone or sotalol. Many atrial fibrillation patients also receive the blood-thinning agent coumadin, since they are at a high risk of developing clots that can lead to a stroke.


Contact: Richard Merritt
Duke University Medical Center

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