Camm and Savalieva [1] provide a clear, concise and practical
description of the
"pill-in-the-pocket" approach to the treatment of paroxysmal atrial
fibrillation
(AF). Anticoagulation therapy is recommended for patients at high risk of
thromboembolism based on the CHADS 2 risk scoring system. However, the 'A'
in the CHADS 2 acronym, as initially described by Gage et al [2] referred
to
'Age>75 years', and not 'Angina' as indicated. Finally, it is worth
noting that the
CHADS 2 scheme should not be applied to patients with AF at high risk of
thromboembolism (eg: patients with mitral stenosis).
1. Camm JA, Savalieva I. Some patients with paroxysmal atrial
fibrillation should
carry flecainide or propafenone to self treat. BMJ 2007; 334: 637.
2. Gage BF, Waterman AD, Shannon W et al. Validation of clinical
classification
schemes for predicting stroke. Results from the National Registry of
Atrial
Fibrillation. JAMA 2001; 285: 2864-70.
Rapid Response:
CHADS 2 and atrial fibrillation
Camm and Savalieva [1] provide a clear, concise and practical
description of the
"pill-in-the-pocket" approach to the treatment of paroxysmal atrial
fibrillation
(AF). Anticoagulation therapy is recommended for patients at high risk of
thromboembolism based on the CHADS 2 risk scoring system. However, the 'A'
in the CHADS 2 acronym, as initially described by Gage et al [2] referred
to
'Age>75 years', and not 'Angina' as indicated. Finally, it is worth
noting that the
CHADS 2 scheme should not be applied to patients with AF at high risk of
thromboembolism (eg: patients with mitral stenosis).
1. Camm JA, Savalieva I. Some patients with paroxysmal atrial
fibrillation should
carry flecainide or propafenone to self treat. BMJ 2007; 334: 637.
2. Gage BF, Waterman AD, Shannon W et al. Validation of clinical
classification
schemes for predicting stroke. Results from the National Registry of
Atrial
Fibrillation. JAMA 2001; 285: 2864-70.
Competing interests:
None declared
Competing interests: No competing interests