BMJ 1996;312:52 (6 January)

Letters

Cardioversion should be attempted

EDITOR,--C M Sudlow and colleagues introduce the concept of packages of care in atrial fibrillation.1 Full packages of care for patients with atrial fibrillation will involve much more than the provision of anticoagulant treatment. Atrial fibrillation causes not only an increased risk of embolism but also important symptoms in itself, especially when the ventricular rate is poorly controlled, and it is an inefficient cardiac rhythm. The aim of treatment should therefore be not only to minimise the risk of embolism but also to achieve good control of the ventricular rate and to restore sinus rhythm when possible. Cardioversion to sinus rhythm improves functional capacity2 and, if maintained, removes the need for long term anticoagulant treatment.

Attempted direct current cardioversion of atrial fibrillation inevitably necessitates referral to secondary care, and patients need anticoagulant treatment before the attempt. This includes young patients with "lone" atrial fibrillation, in whom cardioversion is most likely . . . [Full text of this article]


Add to CiteULike CiteULike   Add to Complore Complore   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Reddit Reddit   Add to StumbleUpon StumbleUpon   Add to Technorati Technorati    What's this?

Relevant Article

How To Do It: Service provision and use of anticoagulants in atrial fibrillation
C M Sudlow, H Rodgers, R A Kenny, and R G Thomson
BMJ 1995 311: 558-560. [Extract] [Full Text]

Access jobs at BMJ Careers
Whats new online at Student BMJ