Key result
Narrative review summarizes antiarrhythmic and anticoagulant monotherapy trials to guide AFib treatment selection.
Why the study?
AF carries an increasing prevalence and mortality, requiring comparison of AADs and ACDs against other agents across various AF types to guide treatment selection.
Do antiarrhythmic and anticoagulant monotherapies improve rate/rhythm control and prevent strokes compared to other drugs in patients with atrial fibrillation?
Do antiarrhythmic and anticoagulant monotherapies improve rate/rhythm control and prevent strokes compared to other drugs in patients with atrial fibrillation?
This narrative review provides a comparative overview of clinical trials evaluating antiarrhythmic and anticoagulant monotherapies versus other drug classes for atrial fibrillation management.
Atrial fibrillation (AF) is a life-changing and life-threatening cardiac electropathological condition, especially in patients with prior history of cardiovascular diseases. This multifaceted condition is one of the top 5 leading causes of cardiovascular death with a rapidly increasing prevalence and death rate. From inception till now, numerous clinical trials have been conducted to explore novel therapeutic targets and strategies along with pre-existing treatments for patients suffering from atrial fibrillation. The pharmacotherapy approach to treat AF (acute, chronic, persistent, paroxysmal, non-valvular, nonrheumatic, and rapid) comprises mainly antiarrhythmic drugs (AAD) and anticoagulant drugs (ACD) for rate and rhythm control along with the prevention of strokes. This narrative review aims to discuss monotherapeutic clinical trials that compared AADs (class II: carvedilol and xamoterol; class III: amiodarone; class IV: verapamil, diltiazem, and nifedipine) and ACDs (vitamin K antagonist: warfarin; factor Xa inhibitor: apixaban; factor IIa and Xa inhibitor: heparin) with cardiac glycoside (digoxin), angiotensin II receptor antagonist (telmisartan), platelet inhibitor (indobufen), anti-convulsant (magnesium sulfate), anti-inflammatory (aspirin), and antipyretic drugs (aspirin) to treat various types of AF in patients with a diverse history of cardiovascular diseases. This study provides a review of all clinical trials on this topic and provides a comparative chart for healthcare professionals to determine the best-suited treatment for their patients.
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Modi et al. (2023) conducted a review in Atrial fibrillation. Antiarrhythmic and anticoagulant drugs vs. Cardiac glycosides, angiotensin II receptor antagonists, platelet inhibitors, anti-convulsants, anti-inflammatories, and antipyretics was evaluated. This narrative review summarizes clinical trials comparing antiarrhythmic and anticoagulant monotherapies with other drug classes to guide treatment selection for patients with atrial fibrillation.
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