Rate-reducing therapy of atrial fibrillation: A new point of view on the old problem

Aim. To study influence of different rate-reducing medicine groups on atrial electrical activity and ventricular thyrhms structure in chronic atrial fibrillation (CAF) and thus to optimize treatment. Material and methods. 57 patients with CA F treated with digitalis, beta-blockers, their combinations, verapamil, amiodaron and sotalol were studied. Repeatedly highly-resolution ECG analysis was made. Results. Atrial fibrillation is characterized by ff-waves basic period from 0, 12 s to 0.20 s. Ventricular characteristics were determined both by A V conduction and basic ff-waves periods. The reducing of basic ff-period is the leading mechanism of digitalis rate-reducing actions in typical cases. The direct AV block appears on the late stage of therapy and is moderate. Conclusion. Combined therapy by medicines with different mechanisms of rate-reducing actions is the most efficient. The choice of the drug and its doses is determined by basic ff-waves periods value and the ventricular rhythm structure.