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Saturday, February 19, 2011

Updated guide for irregular heartbeat


Atrial fibrillation is an irregular heart rhythm that can reduce blood flow and increases the risk of stroke.
Doctors treating Canadians with atrial fibrillation have a new set of guidelines for recognizing and caring for these patients.

Atrial fibrillation is an irregular heart rhythm that can reduce a person's blood flow and increases the risk of stroke by three to five times, cardiologists say. It affects about 250,000 Canadians, according to the Heart and Stroke Foundation.The new guidelines in the February issue of the Canadian Journal of Cardiology seek to reduce the risk of stroke in atrial fibrillation patients.

It also introduces a new anticoagulant option thought to be superior to the current warfarin treatment for some.The new drug, dabigatran, is as effective and easier to use than warfarin, a November 2010 study suggested.Warfarin, also used as pesticide against rats, interacts with some drugs, and patients taking it must have their blood tested regularly to check that they are getting the correct amount.

"This new drug does not have all these constraints, so you take this pill and your anticoagulation level is regular, and is predictable," said Dr. Laurent Macle, a cardiologist at the Montreal Heart Institute and director of the institute's electrophysiology fellowship program.

While dabigatran has advantages, some patient safety advocates point to adverse reactions.
The drug is approved for use in Canada but it is expensive and isn't reimbursed yet by many drug insurance plans, cardiologists said.

The updated guidelines also recommend:

•"Pill-in-pocket" therapy for patients with infrequent and longer-lasting atrial fibrillation that occurs about every three or six months. These patients would replace daily anti-arrhythmic medication with a pill that is taken only when an episode happens, Macle said.

•A new rhythm control therapy called dronedarone that aims to ease symptoms in patients who are sicker with atrial fibrillation.

•Treatment with catheter ablation — cauterizing, or burning, an area in the left atrium of the heart that is responsible for the arrhythmia to prevent recurrences.

The guidelines include a new rating system and tools such as apps for doctors to use.


Read more: http://www.cbc.ca/health/story/2011/02/18/atrial-fibrillation-treatment.html#ixzz1EPWxqdJi

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