Anticoagulants for Treatment of Atrial Fibrillation

Abstract

Theoretically, chronic atrial fibrillation adversely affects individuals with organic heart disease from the standpoint of increased incidence of thromboembolic phenomena and resistant decompensation. This study was designed to demonstrate the effects on rates of morbidity and mortality of anticoagulation and reversion to normal sinus rhythm. Three hundred hospitalized, decompensated cardiac patients with atrial fibrillation of more than 18 days' duration were treated by conventional measures of bed rest, salt restriction, and administration of digitalis and diuretics. One hundred served as a control group; the second 100 received quinidine sulfate and bishydroxycoumarin (Dicumarol); and the third 100 were given bishydroxycoumarin but no quinidine. Rates of mortality and morbidity were highest in the control group and lowest in the second group. Mortality and the nonfatal thromboembolic rates were diminished in the group which received anticoagulants alone, but the incidence of persistent decompensation was unchanged.