Korean J Med.  2018 Apr;93(2):140-152. 10.3904/kjm.2018.93.2.140.

2018 Korean Heart Rhythm Society Guidelines for Antiarrhythmic Drug Therapy in Non-valvular Atrial Fibrillation

Affiliations
  • 1Department of Cardiology, Eulji University Hospital School of Medicine, Deajeon, Korea.
  • 2Department of Cardiology, Korea University Anam Hospital, Korea University College of Medicine, Seoul, Korea. jaemins@korea.ac.kr
  • 3Department of Cardiology, Busan National University College of Medicine, Busan, Korea.
  • 4Department of Cardiology, Chungbuk National University College of Medicine, Chungju, Korea.
  • 5Department of Cardiology, Asan Medical Center, Ulsan University College of Medicine, Seoul, Korea.
  • 6Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea.

Abstract

Rhythm control therapy is the main strategy for restoring and maintaining sinus rhythm in patients with non-valvular atrial fibrillation (NVAF). Sinus rhythm is better restored and maintained with antiarrhythmic drugs than with placebo treatment. In addition, catheter ablation or combination therapy is more effective than antiarrhythmic drugs for treating NVAF. However, in most clinical trials to date, rhythm control therapy has resulted in neutral clinical outcomes compared with rate control therapy. The decision to undergo rhythm control therapy should be based on age, atrial fibrillation (AF)-related symptoms, type of AF, structural heart disease, and underlying comorbidities. For now, rhythm control therapy is indicated to improve symptoms in patients with NVAF who have refractory symptoms after adequate rate control therapy. The Korean Heart Rhythm Society organized the Korean AF Management Guideline Committee and analyzed all available data, including South Korean patients with NVAF. This review article provides general principles and detailed methodology for rhythm control therapy in South Korean patients with NVAF.

Keyword

Atrial fibrillation; Anti-arrhythmia agents; Guidelines

MeSH Terms

Anti-Arrhythmia Agents
Atrial Fibrillation*
Catheter Ablation
Comorbidity
Drug Therapy*
Heart Diseases
Heart*
Humans
Anti-Arrhythmia Agents
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