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Van Gelder IC, Rienstra M, Bunting KV, Casado-Arroyo R, Caso V, Crijns HJGM, De Potter TJR, Dwight J, Guasti L, Hanke T, Jaarsma T, Lettino M, Løchen ML, Lumbers RT, Maesen B, Mølgaard I, Rosano GMC, Sanders P, Schnabel RB, Suwalski P, Svennberg E, Tamargo J, Tica O, Traykov V, Tzeis S, Kotecha D. 2024 ESC Guidelines for the management of atrial fibrillation developed in collaboration with the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 2024; 45:3314-3414. [PMID: 39210723 DOI: 10.1093/eurheartj/ehae176] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/04/2024] Open
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Labbé V, Ederhy S, Legouis D, Joffre J, Razazi K, Sy O, Voicu S, Mekontso-Dessap A, Cohen A, Fartoukh M. Clinical impact of successful cardioversion for new-onset atrial fibrillation in critically ill septic patients: A preliminary study. Arch Cardiovasc Dis 2023; 116:230-233. [PMID: 36805239 DOI: 10.1016/j.acvd.2023.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 01/20/2023] [Accepted: 01/23/2023] [Indexed: 02/11/2023]
Affiliation(s)
- Vincent Labbé
- Service de médecine intensive réanimation, département médico-universitaire APPROCHES, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Groupe de recherche clinique CARMAS, université Paris-Est Créteil, 94010 Créteil, France.
| | - Stephane Ederhy
- Department of Cardiology, UNICO Cardio-Oncology Program, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Inserm U 856, 75013 Paris, France
| | - David Legouis
- Division of Intensive Care, Department of Acute Medicine, University Hospitals of Geneva, 1205 Geneva, Switzerland; Laboratory of Nephrology, Department of Medicine, University Hospitals of Geneva, 1205 Geneva; and Department of Cell Physiology, Faculty of Medicine, University of Geneva, 1211 Geneva, Switzerland
| | - Jérémie Joffre
- Service de médecine intensive réanimation, hôpital Saint-Antoine, AP-HP, Sorbonne université, 75012 Paris, France
| | - Keyvan Razazi
- Groupe de recherche clinique CARMAS, université Paris-Est Créteil, 94010 Créteil, France; Service de médecine intensive réanimation, département médico-universitaire médecine, hôpitaux universitaires Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
| | - Oumar Sy
- Service de médecine intensive réanimation, centre hospitalier melun, groupe hospitalier Sud Ile-de-France, 77000 Melun, France
| | - Sebastian Voicu
- Réanimation médicale et toxicologique, hôpital Lariboisière, AP-HP, université de Paris, Inserm UMRS-1144, 75010 Paris, France
| | - Armand Mekontso-Dessap
- Groupe de recherche clinique CARMAS, université Paris-Est Créteil, 94010 Créteil, France; Service de médecine intensive réanimation, département médico-universitaire médecine, hôpitaux universitaires Henri Mondor-Albert Chenevier, AP-HP, 94000 Créteil, France
| | - Ariel Cohen
- Department of Cardiology, UNICO Cardio-Oncology Program, hôpital Saint-Antoine, AP-HP, 75012 Paris, France; Inserm U 856, 75013 Paris, France; UMR-S ICAN 1166, Sorbonne université, 75013 Paris, France
| | - Muriel Fartoukh
- Service de médecine intensive réanimation, département médico-universitaire APPROCHES, hôpital Tenon, AP-HP, Sorbonne université, 75020 Paris, France; Groupe de recherche clinique CARMAS, université Paris-Est Créteil, 94010 Créteil, France
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Abstract
Rate and rhythm control are still considered equivalent strategies for symptom control using the Atrial Fibrillation Better Care algorithm recommended by the recent atrial fibrillation guideline. In acute situations or critically ill patients, a personalized approach should be used for rapid rhythm or rate control. Even though electrical cardioversion is generally indicated in haemodynamically unstable patients or for rapid effective rhythm control in critically ill patients, this is not always possible due to the high percentage of failure or relapses in such patients. Rate control remains the background therapy for all these patients, and often rapid rate control is mandatory. Short and rapid-onset-acting beta-blockers are the most suitable drugs for acute rate control. Esmolol was the classical example; however, landiolol a newer very selective beta-blocker, recently included in the European atrial fibrillation guideline, has a more favourable pharmacokinetic and pharmacodynamic profile with less haemodynamic interference and is better appropriate for critically ill patients.
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