Atrial fibrillation is the most common arrhythmia in clinical practice. Ion channel blocking agents are often characterized by limited long-term efficacy and several side effects. In addition, ablative invasive procedures are neither easily accessible nor always efficacious. The "upstream therapy," which includes angiotensin-converting enzyme inhibitors, aldosterone receptor antagonists, statins, glucocorticoids, and omega-3 poly-unsaturated fatty acids, targets arrhythmia substrate, influencing atrial structural and electrical remodeling that play an essential role in atrial fibrillation induction and maintenance. The mechanisms involved and the most important clinical evidence regarding the upstream therapy influence on atrial fibrillation are presented in this review. Some open questions are also proposed. (PACE 2011; 111-128).
Upstream Effect for Atrial Fibrillation: Still a Dilemma? / L., Calo; Martino, Annamaria; L., Sciarra; Ciccaglioni, Antonio; E., De Ruvo; L., De Luca; A., Sette; Giunta, Giuseppe; E., Lioy; Fedele, Francesco. - In: PACING AND CLINICAL ELECTROPHYSIOLOGY. - ISSN 0147-8389. - STAMPA. - 34:1(2011), pp. 111-128. [10.1111/j.1540-8159.2010.02942.x]
Upstream Effect for Atrial Fibrillation: Still a Dilemma?
MARTINO, ANNAMARIA;CICCAGLIONI, Antonio;GIUNTA, Giuseppe;FEDELE, Francesco
2011
Abstract
Atrial fibrillation is the most common arrhythmia in clinical practice. Ion channel blocking agents are often characterized by limited long-term efficacy and several side effects. In addition, ablative invasive procedures are neither easily accessible nor always efficacious. The "upstream therapy," which includes angiotensin-converting enzyme inhibitors, aldosterone receptor antagonists, statins, glucocorticoids, and omega-3 poly-unsaturated fatty acids, targets arrhythmia substrate, influencing atrial structural and electrical remodeling that play an essential role in atrial fibrillation induction and maintenance. The mechanisms involved and the most important clinical evidence regarding the upstream therapy influence on atrial fibrillation are presented in this review. Some open questions are also proposed. (PACE 2011; 111-128).I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
