Personalization of therapy in patients with atrial fibrillation: a case report

A clinical case of a 65-year-old man with newly diagnosed AF is presented. The patient consulted a cardiologist because of a first-time paroxysm of atrial fibrillation (AF), which was stopped with medication in hospital (propafenone at a dose of 1.5 mg/kg intravenously for 10 minutes). It is known from the anamnesis that the patient suffers from arterial hypertension and stage I obesity, and previously suffered from gastric bleeding. According to esophagogastroduodenoscopy, chronic Helicobacter erosive active severe gastritis was detected. During the consultation, the patient was recommended anticoagulant therapy (apixaban 5 mg × 2 times a day), gastroenteroprotective therapy (rebamipide 100 mg × 3 times a day + rabeprazole 20 mg 2 times a day), antiarrhythmic therapy (propafenone 150 mg × 3 times) and H. pylori eradication therapy (clarithromycin 500 mg × 2 times a day, amoxicillin 1000 mg × 2 times a day). Using a specific clinical case as an example, the article discusses modern approaches to improving the safety of anticoagulant therapy and choosing a rhythm control strategy in patients with AF.