Heart 2007;93:29-34
MINI-SYMPOSIUM
Rhythm control and cardioversion
1 East Sussex Hospitals NHS Trust, Eastbourne, UK
2 Frimley Park Hospital NHS Foundation Trust, Surrey, UK
3 University Department of Medicine, City Hospital, Birmingham, UK
Correspondence to:
N Sulke
Cardiology Department, East Sussex Hospitals NHS Trust, Eastbourne, UK; neil.sulke@esht.nhs.uk
Abbreviations: ECV, electrical cardioversion; PCV, pharmacological cardioversion; TOE, transoesophageal echocardiography
Keywords: atrial fibrillation
| The first 150 words of the full text of this article appear below. |
The three main aims of treatment for paroxysmal atrial fibrillation are: (1) to suppress paroxysms of atrial fibrillation and maintain long-term sinus rhythm; (2) to control heart rate during paroxysms of atrial fibrillation if they occur; and (3) to prevent the complications associated with paroxysmal atrial fibrillation—that is, stroke and tachycardia-induced cardiomyopathy.1
Many patients with paroxysmal atrial fibrillation can be highly symptomatic, although asymptomatic paroxysms are common.2 However, the abolition of symptoms of paroxysmal atrial fibrillation does not necessarily mean abolition of the atrial fibrillation per se, as heart rate slowing may abolish symptoms but still allow asymptomatic episodes to continue.3 In some patients, it may be appropriate to document the frequency of arrhythmia by Holter monitoring or event recording. Of note, most pharmacological studies of paroxysmal atrial fibrillation have concentrated on the reduction of symptomatic recurrences of paroxysmal atrial fibrillation.
If attacks of paroxysmal atrial fibrillation are frequent, current
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