Guía de práctica clínica para tratamiento de fibrilación auricular

Contenido principal del artículo

Autores

Victor Hugo Forero Supelano

Resumen

El tratamiento de la fibrilación auricular impone retos en cada caso. Nuestro propósito es brindar recomendaciones para el médico en atención primaria. Las fuentes de información principales en la elaboración de la guía fueron estudios primarios y agregativos.

En general, el tratamiento de la fi brilación auricular requiere enfoque individualizado y es altamente recomendable aprovechar de manera pertinente las escalas clínicas disponibles para identificación de beneficios y riesgos según las alternativas terapéuticas.

Para la toma de deciciones hay dos aspectos clave: 1) determinar justificación para profilaxis antitrombótica, 2) evaluar la estrategia más apropiada: control de frecuencia - control de ritmo. Las recomendaciones estan expuestas en tablas y algoritmos que requieren ser utilizadas según el contexto y características individuales en cada caso.

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Detalles del artículo

Licencia

Derechos de autor 2015 Revista Cuarzo

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Referencias

1. Steinberg B, Kim S, Thomas L, et al. Lack of Concordance Between Empirical Scores and Physician Assessments of Stroke and Bleeding Risk in Atrial Fibrillation: Results From the Outcomes Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF) Registry. Circulation. 2014;129(20):20052012.

2. Penado S, Cano M, Acha O, Hernández J, Riancho J. Atrial fibrillation as a risk factor for stroke recurrence. The American Journal of Medicine. 2003;114(3):206210.

3. Abraham JM, Connolly SJ. Atrial fi brillation in heart failure: stroke risk stratification and anticoagulation. Heart Fail Rev. 2014;19(3):305-13.

4. Taggar JS, Coleman T, Lewis S, Heneghan C, Jones M. Accuracy of methods for diagnosing atrial fi brillation using 12-lead ECG: A systematic review and meta-analysis. Int J Cardiol. 2015;184C:175-183.

5. Shi X-MM, Yuan H-TT, Guo H-YY, Guo J-PP, Shan Z-LL, Wang Y-TT. Electrophysiological characteristics of paroxysmal atrial fibrillation originating from superior vena cava: a clinical analysis of 30 cases. Int J Clin Exp Med. 2015;8(1):240-8.

6. Sposato LA, Cipriano LE, Saposnik G, Vargas ER, Riccio PM, Hachinski V. Diagnosis of atrial fi brillation after stroke and transient ischaemic attack: a systematic review and meta-analysis. Lancet Neurol. 2015;14(4):377-87.

7. Luong C, Thompson DJ, Bennett M, et al. Right atrial volume is superior to left atrial volume for prediction of atrial fibrillation recurrence after direct current cardioversion. Can J Cardiol. 2015;31(1):29-35.

8. Yoon YE, Oh I-YY, Kim S-AA, et al. Echocardiographic Predictors of Progression to Persistent or Permanent Atrial Fibrillation in Patients with Paroxysmal Atrial Fibrillation (E6P Study). J Am Soc Echocardiogr. 2015.

9. Bekwelem W, Misialek JR, Konety S, et al. Echocardiographic measures of cardiac structure and function are associated with risk of atrial fi brillation in blacks: the Atherosclerosis Risk in Communities (ARIC) study. PLoS ONE. 014;9(10):e110111.

10. Al-Khatib SM, Allen LaPointe NM, Chatterjee R, et al. Rate and rhythm-control therapies in patients with atrial fi brillation: a systematic review. Ann Intern Med. 2014;160(11):760-73.

11. Oldgren J, Alings M, Darius H, et al. Risks for stroke, bleeding, and death in patients with atrial fi brillation receiving dabigatran or warfarin in relation to the CHADS2 score: a subgroup analysis of the RE-LY trial. Annals of internal medicine. 2011;155(10):660-7, W204.

12. Dzeshka M, Lane D, Lip G. Stroke and Bleeding Risk in Atrial Fibrillation: Navigating the Alphabet Soup of Risk-Score Acronyms (CHADS2, CHA2DS2-VASc, R2CHADS2, HAS-BLED, ATRIA, and More). Clinical Cardiology. 2014;37(10):634-644.

13. Hrynkiewicz-Szymanska A, Dluzniewski M, Platek AE, et al. Association of the CHADS2 and CHA 2DS 2-VASc scores with left atrial enlargement: a prospective cohort study of unselected atrial fibrillation patients. J Thromb Thrombolysis. 2014.

14. Albertsen I, Rasmussen L, Overvad T, Graungaard T, Larsen T, Lip G. Risk of Stroke or Systemic Embolism in Atrial Fibrillation Patients Treated With Warfarin A Systematic Review and Metaanalysis. Stroke. 2013;44(5):1329-1336.

15. Senoo K, Lip GY. Comparative efficacy and safety of the non-vitamin k antagonist oral anticoagulants for patients with nonvalvular atrial fi brillation. Semin Thromb Hemost. 2015;41(2):146-53.

16. Dentali F, Botto GL, Gianni M, Ambrosino P, Di Minno MN. Efficacy and safety of direct oral anticoagulants in patients undergoing cardioversion for atrial fibrillation: A systematic review and meta-analysis of the literature. Int J Cardiol. 2015;185:72-77.

17. Basili S, Raparelli V, Proietti M, Napoleone L, Ferroni P, Franconi F. Old And New Oral Anticoagulants In Management Of Atrial Fibrillation: A Double-Edged Sword For Women. Curr Vasc Pharmacol. 2015.

18. Cope S, Clemens A, Hammès F, Noack H, Jansen JP. Critical appraisal of network meta-analyses evaluating the efficacy and safety of new oral anticoagulants in atrial fi brillation stroke prevention trials. Value Health. 2015;18(2):234-49.

19. Claridge SB, Kanaganayagam GS, Kotecha T. Atrial fi brillation guidelines. Don’t forget HASBLED score. BMJ. 2011;342:d3205.

20. Scowcroft AC, Lee S, Mant J. Thromboprophylaxis of elderly patients with AF in the UK: an analysis using the General Practice Research Database (GPRD) 2000-2009. Heart. 2013;99(2):127-32.

21. Stępińska J, Czerwińska K, Witkowski A, et al. Risk factors for bleeding complications in patients undergoing transcatheter aortic valve implantation (TAVI). Cardiol J. 2013;20(2):125-33.

22. Chiang C-EE, Naditch-Brûlé L, Murin J, et al. Distribution and risk profile of paroxysmal, persistent, and permanent atrial fibrillation in routine clinical practice: insight from the real-life global survey evaluating patients with atrial fibrillation international registry. Circ Arrhythm Electrophysiol. 2012;5(4):632-9.

23. Chan N, Paikin J, Hirsh J, Lauw M, Eikelboom J, Ginsberg J. New oral anticoagulants for stroke prevention in atrial fibrillation: impact of study design, double counting and unexpected findings on interpretation of study results and conclusions. Thrombosis and Haemostasis. 2014;111(5):798807.

24. Ahmad Y, Lip GY, Apostolakis S. New oral anticoagulants for stroke prevention in atrial fibrillation: impact of gender, heart failure, diabetes mellitus and paroxysmal atrial fibrillation. Expert Rev Cardiovasc Ther. 2012;10(12):1471-80.

25. Chugh SS, Roth GA, Gillum RF, Mensah GA. Global burden of atrial fi brillation in developed and developing nations. Glob Heart. 2014;9(1):113-9.

26. Alonso A, Krijthe BP, Aspelund T, et al. Simple risk model predicts incidence of atrial fi brillation in a racially and geographically diverse population: the CHARGE-AF consortium. J Am Heart Assoc. 2013;2(2):e000102.

27. Healey JS, Connolly SJ, Gold MR, et al. Subclinical atrial fibrillation and the risk of stroke. N Engl J Med. 2012;366(2):120-9.

28. Wachter R, Stahrenberg R, Gröschel K. Subclinical atrial fi brillation: how hard should we look? Heart. 2013;99(3):151-3.

29. Yoneyama K, Harada T, Ito H, et al. Subclinical atrial fi brillation preceding cardioembolic stroke in a patient with systolic heart failure. Int J Cardiol. 2014;176(3):1036-8.

30. Benezet-Mazuecos J, Rubio JM, Cortés M, et al. Silent ischaemic brain lesions related to atrial high rate episodes in patients with cardiac implantable electronic devices. Europace. 2015;17(3):364-9.

31. Hohnloser SH, Kuck KH, Lilienthal J. Rhythm or rate control in atrial fibrillation--Pharmacological Intervention in Atrial Fibrillation (PIAF): a randomised trial. Lancet. 2000;356(9244):1789-94.

32. Carlsson J, Miketic S, Windeler J, et al. Randomized trial of ratecontrol versus rhythm-control in persistent atrial fi brillation: the Strategies of Treatment of Atrial Fibrillation (STAF) study. J Am Coll Cardiol. 2003;41(10):1690-6.

33. Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825-33.

34. Van Gelder IC, Van Veldhuisen DJ, Crijns HJ, et al. RAte Control Efficacy in permanent atrial fibrillation: a comparison between lenient versus strict rate control in patients with and without heart failure. Background, aims, and design of RACE II. Am Heart J. 2006;152(3):420-6.

35. Freudenberger RS, Wilson AC, Kostis JB. Comparison of rate versus rhythm control for atrial fibrillation in patients with left ventricular dysfunction (from the AFFIRM Study). Am J Cardiol. 2007;100(2):247-52.

36. Van Gelder IC, Groenveld HF, Crijns HJ, et al. Lenient versus strict rate control in patients with atrial fibrillation. N Engl J Med. 2010;362(15):1363-73.

37. Smit MD, Crijns HJ, Tijssen JG, et al. Effect of lenient versus strict rate control on cardiac remodeling in patients with atrial fi brillation data of the RACE II (RAte Control Effi cacy in permanent atrial fi brillation II) study. J Am Coll Cardiol. 2011;58(9):942-9.

38. Weipert KF, Erkapic D, Schmitt J. [Rate and rhythm control in atrial fibrillation: Pharmacological approaches]. Herz. 2015;40(1):16-24.

39. Rolf S, Kornej J, Dagres N, Hindricks G. What can rhythm control therapy contribute to prognosis in atrial fi brillation? Heart. 2015.

40. Heidbuchel H, Verhamme P, Alings M, et al. European Heart Rhythm Association Practical Guide on the use of new oral anticoagulants in patients with non-valvular atrial fi brillation. Europace. 2013;15(5):625-651.

41. Ruff CT, Giugliano RP, Braunwald E, et al. Comparison of the efficacy and safety of new oral anticoagulants with warfarin in patients with atrial fibrillation: a meta-analysis of randomised trials. Lancet. 2014;383(9921):955-62.

42. Wallentin L, Lopes RD, Hanna M, et al. Effi cacy and safety of apixaban compared with warfarin at different levels of predicted international normalized ratio control for stroke prevention in atrial fibrillation. Circulation. 2013;127(22):2166-76.

43. Connolly SJ, Ezekowitz MD, Yusuf S, et al. Dabigatran versus warfarin in patients with atrial fi brillation. N Engl J Med. 2009;361(12):1139-51.

44. Patel MR, Mahaffey KW, Garg J, et al. Rivaroxaban versus warfarin in nonvalvular atrial fi brillation. N Engl J Med. 2011;365(10):883-91.

45. Freemantle N, Lafuente-Lafuente C, Mitchell S, Eckert L, Reynolds M. Mixed treatment comparison of dronedarone, amiodarone, sotalol, fl ecainide, and propafenone, for the management of atrial fi brillation. Europace. 2011;13(3):329-45.

46. Lafuente-Lafuente C, Valembois L, Bergmann J-FF, Belmin J. Antiarrhythmics for maintaining sinus rhythm after cardioversion of atrial fi brillation. Cochrane Database Syst Rev. 2015;3:CD005049.

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