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Atrial Fibrillation: Nonpharmacologic Therapies Coming of Age

Roy M. John, MD, PhD; Gregory Michaud, MD
Author and Funding Information

Affiliations: Burlington, MA
 ,  Dr. John is Director, Cardiac Electrophysiology Laboratory, and Dr. Michaud is Director, Atrial Fibrillation Center, Lahey Clinic Medical Center, Burlington, MA.

Correspondence to: Roy M. John, MD, PhD, Department of Cardiology, Lahey Clinic, 41 Mall Rd, Burlington, MA 01805; e-mail: roy.m.john@lahey.org



Chest. 2004;125(6):1977-1979. doi:10.1378/chest.125.6.1977
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Extract

Atrial fibrillation is a common arrhythmia present in 0.4% of the population. Its prevalence increases with age and in the presence of structural heart disease. Although seldom life threatening, it is associated with morbidity primarily related to symptoms, thromboembolism, and heart failure. Once patients experience recurrent episodes of atrial fibrillation, pharmacologic rhythm control (maintenance of sinus rhythm) is at best partly effective. However, when patients are relatively symptom free, a strategy of heart rate control in atrial fibrillation is equivalent to one of rhythm control in terms of quality-of-life measures and all-cause mortality, although superior in reducing hospitalization.1 In either strategy, anticoagulation should be maintained in patients at high risk of thromboembolism.

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