New possibilities of using IC class drugs for sinus rhythm retention in paroxysmal atrial fibrillation

The not always justified fears about the antiarrhythmic therapy safety have been making us to believe that the strategies to control ventricular contraction rhythm and rate during treatment of atrial fibrillation (AF) are clinically equivalent for two decades, but to date the opinion has shifted dramatically. The results of modern research have led to changes in the paradigm of managing patients with AF and the emergence of the guidelines to use rhythm control as a preferred treatment strategy that should be used in the vast majority of patients with paroxysmal AF. The data acquired when conducting the Early Treatment of Atrial Fibrillation for Stroke Prevention Trial (EAST-AFNET 4) suggest safety of treating the patients having arterial hypertension, stable course of coronary artery disease, and chronic heart failure with preserved left ventricular ejection fraction with IC class drugs. Comprehensive clinical assessment of the patient’s condition, including making the decision about prescription of the antiarrhythmic drug and determination of the appropriate dose, represents the most important component of AF treatment.