Q: Which one is of more importance in the management of atrial fibrillation, regulating the heart rhythm or slowing the heart rate?
A: In an article published in the Journal of American Medical Association (JAMA), Dr. Fred Morady expresses his ideas:
1) For patients under the age of 65, regulating the heart rhythm is more essential than lowing the heart rate. According to the data from previous studies, the survival rate of the former is higher than that of the latter.
2) Among elderly people whose average age is about 70, the method of regulating the heart rhythm is no longer superior to the other way.
Dr. White thinks that the following three questions should be taken into account.
1) Do the symptoms of the patient begin recently?
2) Is the rate of the patient’s CHA2DS2-VASc between 0 - 1?
3) Is the result of the patient’s QTc under 460?
If all the answers of the above three questions are yes
, you should regulate your heart rhythm first. Otherwise, you must ask a cardiologist for advice.
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