NEW DRUG THERAPIES FOR DIFFICULT-TO-CONTROL ATRIAL FIBRILLATION

Chicago, IL—“Difficult” atrial fibrillation (AF), for which standard ratecontrol therapy or standard rhythmcontrol therapy has not been effective, or AF in the setting of sinus node or other conduction disease, has been shown to sometimes benefit from nonstandard or combination-drug treatment, according to James A. Reiffel, MD, Professor of Clinical Medicine, Columbia University Medical Center, New York City.

For patients in whom ventricular rate control cannot be attained with beta-blockers, calcium channel blockers, and/or digitalis, nonhepatically metabolized beta-blockers may be an option. Serum concentrations of metoprolol (Lopressor, Toprol) or propranolol (Inderal, Inderal LA, Innopran XL), for example, can vary up to 10-fold for the same dose, partially the result of high first-pass effects. Read more