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Guidelines Eased for Patients With Irregular Heartbeats
Date:12/20/2010

nt, and the long-term effects of persistent arrhythmias on the ventricles are still of concern, Dr. L. Samuel Wann, chair of the focused-update writing group, said in a news release from the heart organizations.

The updated recommendations are reported in the Dec. 20 online edition and the Jan. 4 print issue of the journal Circulation. They will also be published in the Journal of the American College of Cardiology and HeartRhythm. The purpose of the update is to get new findings incorporated into patient care as quickly as possible.

Fonarow noted that the new thinking could lead to patients taking fewer daily medications, more convenient treatment and perhaps the elimination of significant side effects from some of the drugs.

"For patients on six to nine medications, that's a big difference," he said. "They can get comparable quality of life with less meds. The focus can be to make sure they're protected adequately from the risk of stroke."

Other treatment changes in the updated guidelines include:

  • Prescribing a combination of aspirin and the clot-preventing drug Plavix (clopidogrel) for patients who are poor candidates for Coumadin (warfarin), a powerful clot-preventing drug that requires regular testing to assess its effectiveness and correct dosage.
  • Prescribing dronedarone, a pill that controls heart rhythm, in place of amiodarone, another anti-arrhythmic, to reduce side effects and hospitalizations.
  • Supporting the greater use of catheter ablation, a procedure that utilizes radiofrequency energy to destroy small areas of tissue in the heart responsible for irregular heartbeat.

Fonarow said he was disappointed the revised guidelines could not recommend the use of the new anti-clotting drug dabigatran, which was approved by the U.S. Food and Drug Administration in October.

"Because of the timing, it's not addressed in this report," Fonarow said. "I certainly look forward
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