Mar 11, 2004

Ventricular rate control during atrial fibrillation and AV node modifications: past, present, and future

Pacing and Clinical Electrophysiology : PACE
Youhua Zhang, T Mazgalev


Atrial fibrillation (AF) is the most common arrhythmia. Currently there are two broad strategic treatment options for AF: rhythm control and rate control. For rhythm control, the treatment is directed toward restoring and maintaining the sinus rhythm. For rate control, the intention is to slow ventricular rate while allowing AF to continue. In both cases anticoagulation therapy is recommended. The results of currently available clinical trials demonstrated clearly that rate control is not inferior to rhythm control. Thus, rate control is an acceptable primary therapy for many AF patients. The rate control can be achieved essentially by depressing or modifying the filtering properties of the atrioventricular (AV) node. This can be attained by medications that depress the impulse transmission within the AV node, by anatomic modification of the AV communications, as well as by autonomic manipulations that produce AV node negative dromotropic effect. We are reviewing current clinical and newer experimental modalities aimed at enhancing the lifesaving function of this remarkable nodal structure.

Mentioned in this Paper

Myocardial Contraction
Negative Regulation of Coagulation
Sinus - General Anatomical Term
Vagus Nerve Structure
Decreased Coagulation Activity [PE]
Atrial Fibrillation
Cardiac Depressants
Structure of Atrioventricular Node
Ventricular Function
NODAL gene

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