You Should Treat the Heart Rate in Atrial Fibrillation Only This Way
Автор: Iabluchanskyi M., MD, PhD, DMSc, Prof.
Загружено: 2025-11-17
Просмотров: 15
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Об этом видео: You Should Treat the Heart Rate in Atrial Fibrillation Only This Way
Patients with atrial fibrillation usually preserve a positive rate-adaptive response. Their heart rate rises appropriately in response to physical effort, which is why many can tolerate even intensive activity without experiencing shortness of breath. When treatment slows the heart rate too much and dyspnea appears, this signals that the medication has been overdosed and the normal rate-adaptive response has been suppressed.
For this reason, dose titration must aim for controlled heart rate reduction while preserving the patient’s ability to increase heart rate during physical stress. This balance is the essence of correct rate control in atrial fibrillation.
If this approach sounds demanding, it is. Anything effortless rarely delivers meaningful clinical value.
Heart Rate-Reducing Medications in AF
Medications that reduce the heart rate in atrial fibrillation can be
categorized by their antiarrhythmic classes (Vaughan Williams
classification) and related pharmacological groups:
Class II: Beta-blockers
• Metoprolol
• Atenolol
• Bisoprolol
• Carvedilol
• Propranolol
• Nadolol
Class IV: Non-dihydropyridine Calcium Channel Blockers
• Diltiazem
• Verapamil
Class III: Potassium Channel Blockers (mainly rhythm control,
but sometimes adjunct for rate)
• Amiodarone
• Sotalol
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