Antiarrhythmic drug therapy for atrial fibrillation: Are the guidelines guiding clinical practice?

James A. Reiffel, Gerald V. Naccarelli

Research output: Contribution to journalReview article

15 Scopus citations


The AFFIRM study showed no clear survival advantage for a rhythm versus rate control strategy in patients with atrial fibrillation (AF). However, rhythm control with antiarrhythmic drugs (AADs) is appropriate in a large number of patients with AF. The American College of Cardiology/ American Heart Association/European Society of Cardiology AF management guidelines include a safety-based algorithm for selection of AAD therapy. Class 1C agents are recommended as first-line therapy in patients without or with minimal structural heart disease. However, market research and clinical study data indicate a growing use of class III agents (mainly amiodarone) despite long-term safety and tolerability concerns, suggesting that clinical practice does not adhere to current guidelines.

Original languageEnglish (US)
Pages (from-to)97-102
Number of pages6
JournalClinical Cardiology
Issue number3
StatePublished - Mar 1 2006


All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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