The Pharmacological Management of Atrial Fibrillation

A tétel rövid nézete
dc.contributor.advisorPórszász, Róbert
dc.contributor.advisordeptDebreceni Egyetem::Általános Orvostudományi Kar::Farmakológiai és Farmakoterápiai Intézethu_HU
dc.contributor.authorAlqarni, Sultan
dc.contributor.departmentDE--Általános Orvostudományi Karhu_HU
dc.contributor.opponentSzentmiklósi, József András
dc.contributor.opponentDrimba, László
dc.contributor.opponentdeptDebreceni Egyetem::Általános Orvostudományi Kar::Farmakológiai és Farmakoterápiai Intézethu_HU
dc.contributor.opponentdeptKenézy Kórház Aneszteziológiai és Intenziv Therápiás Osztályhu_HU
dc.date.accessioned2016-07-21T19:07:22Z
dc.date.available2016-07-21T19:07:22Z
dc.date.created2016-03-22
dc.description.abstractAtrial fibrillation (AF) is the most common cardiac arrhtymia affecting 1-2% of the European population and nearly 6.1 million Americans. The elderly are at a greater risk with 9% of people over 65 years of age having AF.It costs the European Union 3 billion euros and the USA 6 billion dollars per year to treat the disease, its complications and underlying causes. The most common presentation is palpitations, fast irregular pulse, dyspnoea, chest pain, dizziness and fatigue. The cause of the condition is multifactorial and includes genetic mutations, structural cardiac diseases and electrophysiological malfunctions of the heart. All these may be triggered by several risk factors. They include age, male gender, European ancestry, genetic predispositions, obesity, diabetes mellitus, hypertension, chronic kidney disease, and presence of some elevated serum biomarkers,namely BNP and CRP. After physical examination and history taking, a electrocardiogram (ECG) should be done. AF patients have no P waves and irregular RR distances on their ECG. Their heart rate may be over 300 beats per minute. A transesophageal echocardiography (TEE) may be done to confirm diagnsosis, along with blood tests to exclude other causes of the presenting symtoms. Patients should then be classified into categories based on their symptoms severity and risk factors. This categories then determine the management method applied. In all patients, antithrombotic therapy should be initiated to prevent one of the complications of AF, stroke from occuring. Anticoagulants such as warfarin or the newer dabigatran, apixaban or rivaroxaban may be used for high risk patients. Anti-platelet therapy is often given to patients in the intermediate risk category. This may be in form of aspirin, clopidogrel, prasugrel or ticagrelor although aspirin is the most commonly used drug. Antiarrhtyhmic treatment should be initiated in a recent onset AF. Availble drugs are often sodium and potassium channel blockers. They include Quinidine, Flecainide, Propafenone, Sotalol, Dofetilide, Amiodarone, Dronedarone, Vernakalant and Ibutilide. Rate control to prevent ventricular arrhythmia may be done using drugs such as beta blockers, calcium channel blockers, cardiac glycosides and others. Upstream therapy for cardioprotection and to prevent the generation of AF can be achieved using Angiotension Converting Enzyme Inhibitors (ACEI) and Angiotension Receptor Blockers (ARBs), statins and Polyunsaturated Fatty Acids (PUFAs). This thesis gives an overview of AF and discusses the pharmacological management in detail.hu_HU
dc.description.correctorhbk
dc.description.courseáltalános orvoshu_HU
dc.description.courselangmagyarhu_HU
dc.description.degreeegységes, osztatlanhu_HU
dc.format.extent31hu_HU
dc.identifier.urihttp://hdl.handle.net/2437/229596
dc.language.isoenhu_HU
dc.subjectAtrial fibrillationhu_HU
dc.subjectpharmacological managementhu_HU
dc.subjectarrhythmiahu_HU
dc.subject.dspaceDEENK Témalista::Orvostudományhu_HU
dc.titleThe Pharmacological Management of Atrial Fibrillationhu_HU
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Gyűjtemények
Theses (Faculty of Medicine)