I thought this was interesting, I hope you can read the article without being a member. if not let me know. here is part of the article
http://www.theheart.org/article/1141079.do
Montreal, QC - The Canadian Cardiovascular Society (CCS) released new guidelines for the treatment of atrial fibrillation this week at the Canadian Cardiovascular Congress 2010, and in the soon-to-be-published document experts make specific recommendations on the use of catheter ablation, as well as new recommendations on some of the newer anticoagulant and antiarrhythmic medications.
Dr Michelle Graham (University of Edmonton, AB), the chair of the CCS guidelines committee, said that the burden of atrial fibrillation continues to grow in Canada and worldwide, but the emergence of new treatments and procedures necessitated an update to the Canadian guidelines, which were last updated in 2004.
The new treatment recommendations incorporate the new anticoagulant dabigatran (Pradaxa, Boehringer Ingelheim), recently approved by the US Food and Drug Administration (FDA) for the prevention of stroke and systemic embolism in patients with atrial fibrillation, even though the drug is not yet approved in Canada. Graham told heartwire that the purpose of including dabigatran in the 2010 recommendations is to have the guidelines as current as possible, and that includes making recommendations on drugs expected to soon be in the armamentarium of practicing clinicians.
"The guidelines are very cutting edge," said Graham. "It has recommendations for drugs that are not yet approved, so those recommendations are going to be held back unless the drugs get approved. We've gone so far as to assess the drugs that have been evaluated in clinical trials, so that we actually have a position on them. If Health Canada approves the drugs before the guidelines are published, the recommendations are in. If they don't approve the drugs, then recommendations won't be included in the update. It's very contemporary.".....
...In addition to incorporating dabigatran into the Canadian guidelines, the atrial-fibrillation committee also provided guidance on the use of radiofrequency catheter ablation. According to the committee, catheter ablation is recommended in patients "who remain symptomatic following adequate trials of antiarrhythmic drug therapy and in whom a rhythm-control strategy remains desired."
"If you fail an antiarrhythmic drug, we have a conditional recommendation that ablation can then be considered," said Skanes. "It's based on patients with mild to moderate heart disease, and it's pretty wide sweeping, as long as you have a reasonably normal heart, structurally, and if you fail a drug, we suggest it as an alternative. It's a conditional recommendation, moderate in its quality of evidence. The European guidelines did something very similar."...
There is more at the link with a ps that "On October 27, one day after this story was published, Health Canada announced it had approved dabigatran for the prevention of stroke and systemic embolism in patients with atrial fibrillation. The drug will be marketed as Pradax"
http://www.theheart.org/article/1141079.do
Montreal, QC - The Canadian Cardiovascular Society (CCS) released new guidelines for the treatment of atrial fibrillation this week at the Canadian Cardiovascular Congress 2010, and in the soon-to-be-published document experts make specific recommendations on the use of catheter ablation, as well as new recommendations on some of the newer anticoagulant and antiarrhythmic medications.
Dr Michelle Graham (University of Edmonton, AB), the chair of the CCS guidelines committee, said that the burden of atrial fibrillation continues to grow in Canada and worldwide, but the emergence of new treatments and procedures necessitated an update to the Canadian guidelines, which were last updated in 2004.
The new treatment recommendations incorporate the new anticoagulant dabigatran (Pradaxa, Boehringer Ingelheim), recently approved by the US Food and Drug Administration (FDA) for the prevention of stroke and systemic embolism in patients with atrial fibrillation, even though the drug is not yet approved in Canada. Graham told heartwire that the purpose of including dabigatran in the 2010 recommendations is to have the guidelines as current as possible, and that includes making recommendations on drugs expected to soon be in the armamentarium of practicing clinicians.
"The guidelines are very cutting edge," said Graham. "It has recommendations for drugs that are not yet approved, so those recommendations are going to be held back unless the drugs get approved. We've gone so far as to assess the drugs that have been evaluated in clinical trials, so that we actually have a position on them. If Health Canada approves the drugs before the guidelines are published, the recommendations are in. If they don't approve the drugs, then recommendations won't be included in the update. It's very contemporary.".....
...In addition to incorporating dabigatran into the Canadian guidelines, the atrial-fibrillation committee also provided guidance on the use of radiofrequency catheter ablation. According to the committee, catheter ablation is recommended in patients "who remain symptomatic following adequate trials of antiarrhythmic drug therapy and in whom a rhythm-control strategy remains desired."
"If you fail an antiarrhythmic drug, we have a conditional recommendation that ablation can then be considered," said Skanes. "It's based on patients with mild to moderate heart disease, and it's pretty wide sweeping, as long as you have a reasonably normal heart, structurally, and if you fail a drug, we suggest it as an alternative. It's a conditional recommendation, moderate in its quality of evidence. The European guidelines did something very similar."...
There is more at the link with a ps that "On October 27, one day after this story was published, Health Canada announced it had approved dabigatran for the prevention of stroke and systemic embolism in patients with atrial fibrillation. The drug will be marketed as Pradax"
