Recomandarile pentru gestionarea pacientilor cu fibrilatie atriala

2 Septembrie, 2010 - 23:00

Sanatate

Expertii American Academy of Family Physicians si ai American College of Physicians au facut recomandari pentru gestionarea pacientilor cu fibrilatie atriala. Recomandarile nu se aplica fibrilatiei postoperatorii, post-infarct, pacientilor cu insuficienta cardiaca de clasa IV, celor care au deja in tratament medicamente aritmice sau pacientilor cu afectiuni valvulare jogos casino online.

Prima recomandare priveste controlul frecventei ventriculare asociat terapiei anticoagulante si strategiei aplicate la majoritatea pacientilor cu fibrilatie atriala. Controlul ritmului sinusal nu a demonstrat a fi superior controlului frecventei ventriculare in reducerea morbiditatii si mortalitatii.

Dimpotriva, in anumite subgrupe de pacienti controlul ritmului sinusal a dat
rezultate inferioare controlului frecventei. Conform celei de-a doua recomandari, pacientii cu fibrilatie atriala trebuie supusi terapiei anticoagulante cu warfarina, mai putin cei care prezinta risc de ictus sau contraindicatii specifice la acest medicament (trombocitopenia, trauma sau interventie chirurgicala recenta, alcoolism).

Atenololul, metoprololul, diltiazememul si verapamilul sunt recomandate in cel de-al treilea caz la pacientii cu fibrilatie atriala pentru a controla frecventa ventriculara. Pentru pacientii la care este aleasa cardioversiunea fibrilatiei atriale a ritmului sinusal cele doua optiuni sunt cardioversiunea electrica sau cea farmacologica. (AAFP/ACP)

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