From the Guidelines
To manage persistent atrial fibrillation (AF) rhythm, the most recent guidelines recommend a treatment approach focused on rhythm control, with the goal of maintaining sinus rhythm and reducing symptoms. According to the 2024 ESC guidelines for the management of atrial fibrillation 1, persistent AF is defined as AF episodes that are not self-terminating, and treatment options include pharmacological cardioversion, electrical cardioversion, and antiarrhythmic drug therapy.
The choice of treatment depends on the patient's underlying heart disease, symptoms, and risk of side effects. For patients with persistent AF, antiarrhythmic drugs such as amiodarone, propafenone, and sotalol may be used to maintain sinus rhythm 1. Amiodarone is often used as a last-resort agent due to its potential side effects, but it has been shown to be effective in maintaining sinus rhythm in patients with persistent AF.
Some key points to consider when managing persistent AF rhythm include:
- The use of antiarrhythmic drugs to maintain sinus rhythm, with amiodarone being a commonly used option
- The importance of considering the patient's underlying heart disease and symptoms when choosing a treatment approach
- The need for regular monitoring and follow-up to adjust treatment as needed
- The potential benefits of rhythm control in reducing symptoms and improving quality of life
It's also important to note that the treatment approach may vary depending on the individual patient's needs and circumstances. A thorough evaluation and discussion with a healthcare provider is necessary to determine the best course of treatment for persistent AF rhythm.
From the Research
Persist Allergy Rhythm
- Allergic rhinitis is a common and chronic immunoglobulin E-mediated respiratory illness that can affect quality of life and productivity, as well as exacerbate other conditions such as asthma 2.
- The treatment of allergic rhinitis should be based on the patient's age and severity of symptoms, and patients should be educated about their condition and advised to avoid known allergens 2, 3.
- Intranasal corticosteroids are the most effective treatment and should be first-line therapy for persistent symptoms affecting quality of life 2, 3, 4.
- Second-line therapies for allergic rhinitis include antihistamines, decongestants, cromolyn, leukotriene receptor antagonists, and nonpharmacologic therapies such as nasal irrigation 2, 3.
- Subcutaneous or sublingual immunotherapy should be considered if usual treatments do not adequately control symptoms and in patients with allergic asthma 2, 4.
- Recent pharmacological developments in the treatment of perennial and persistent allergic rhinitis include MP-AzeFlu, a novel intranasal formulation of azelastine hydrochloride and fluticasone propionate, which has surpassed available therapies in terms of symptom control and treatment response 5.
- Other relatively new treatments for perennial and persistent allergic rhinitis include H3 antihistamines, toll-like receptor agonists, cellulose powders and micro-emulsions, novel biomolecular formulations, and omalizumab 5.