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| ==Antiarrhythmic Drug Therapy in Atrial Fibrillation==
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| Shown below is an algorithm depicting the antiarrhythmic drug therapy for maintain sinus rhythm in patients with recurrent paroxysmal or persistent atrial fibrillation:
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| {{familytree/start |summary=PE diagnosis Algorithm.}}
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| {{familytree| | | | | | | | | | | | | | | A01 | | | | | | A01=Maintenance of [[sinus rhythm]]}}
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| {{familytree| | | |,|-|-|-|-|-|-|-|v|-|-|-|^|-|-|-|v|-|-|-|-|-|.| | }}
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| {{familytree| | | B01 | | | | | | B02 | | | | | | B03 | | | | B04 | B01=No (or minimal) heart disease| B02=[[Hypertension]]| B03=[[Coronary artery disease]]| B04=[[Heart failure]]}}
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| {{familytree| | | |!| | | | | | | |!| | | | | | | |!| | | | | |!| | | | | |}}
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| {{familytree| | | C01 | | | | | | C02 | | | | | | C03 | | | | C04 | | | | C01=[[Dronedarone]] <br> [[Flecainide]]<br>[[Propafenone]]<br>[[Sotalol]]| C02=Substantial [[LVH]]|C03=[[Dronedarone]] <br>[[Dofetilide]]<br>[[Sotalol]]|C04=[[Amiodarone]]<br>[[Dofetilide]]}}
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| {{familytree| |,|-|^|-|.| | | |,|-|^|-|.| | | |,|-|^|-|.| | | |!| | | | | | |}}
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| {{familytree| D01 | | D02 | | D03 | | D04 | | D05 | | D06 | | D07 | | | | | | ||D01=[[Amiodarone]]<br>[[Dofetilide]]|D02=[[Catheter ablation]]|D03=No|D04=Yes|D05=[[Amiodarone]]|D06=[[Catheter ablation]]|D07=[[Catheter ablation]]}}
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| {{familytree| | | | | | | | | |!| | | |!| | | | | | | |}}
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| {{familytree| | | | | | | | | E01 | | E02 | | | | | E01=[[Dronedarone]] <br> [[Flecainide]]<br>[[Propafenone]]<br>[[Sotalol]]|E02=[[Amiodarone]]}}
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| {{familytree| | | | | | | | | |!| | | |!| | | | | | | |}}
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| {{familytree| | | | | | | | | |!| | | F03 | | | | | | |F03=[[Catheter ablation]]}}
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| {{familytree| | | | | | | |,|-|^|-|.| | | | | | | | | | | | | | }}
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| {{familytree| | | | | | | F01 | | F02 | | | | | | | | | F01=[[Amiodarone]]<br>[[Dofetilide]]|F02=[[Catheter ablation]]}}
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| {{familytree/end}}
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| Drugs are listed alphabetically and not in order of suggested use. <br>The seriousness of heart disease progresses from left to right, and selection of therapy in patients with multiple conditions depends on the most serious condition present.<br> LVH indicates left ventricular hypertrophy.<br>
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| ''Algorithm based on the 20011 ACCF/AHA/HRS updates for the management of atrial fibrillation.''<ref name="Fuster-2011">{{Cite journal | last1 = Fuster | first1 = V. | last2 = Rydén | first2 = LE. | last3 = Cannom | first3 = DS. | last4 = Crijns | first4 = HJ. | last5 = Curtis | first5 = AB. | last6 = Ellenbogen | first6 = KA. | last7 = Halperin | first7 = JL. | last8 = Kay | first8 = GN. | last9 = Le Huezey | first9 = JY. | title = 2011 ACCF/AHA/HRS focused updates incorporated into the ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. | journal = Circulation | volume = 123 | issue = 10 | pages = e269-367 | month = Mar | year = 2011 | doi = 10.1161/CIR.0b013e318214876d | PMID = 21382897 }}</ref>
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| * Dabigatran may be used as an alternative to warfarin in those wdo don't have: (I B)
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| :* Prosthetic heart valve
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| :* Hemodynamically significant valve disease
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| :* Severe renal failure (creatinine clearance <15 mL/min) or
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| :* Advanced liver disease (impaired baseline clotting function).
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| * If patient on anticoagulants with AF sustains stroke or systemic embolism, target INR may be raised to 3.0 - 3.5 (IIb C).
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| * Anticoagulation therapy can be interrupted for upto 1 week, if patients needs a procedure that carries a risk of bleeding (IIa C). For periods > 1 week unfractionated or low molecular weight heparin may be given IV (IIb C).
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