The Pharmaceutical Journal
Vol 270 No 7232 p92
18 January 2003

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A useful resource for the management of atrial fibrillation

'Atrial fibrillation in practice' 1st edition, by Gregory Y. H. Lip. Pp viii+68. London: The Royal Society of Medicine Press Ltd; 2002. ISBN 1 85315 484 9

Atrial fibrillation is a common disorder but its management and treatment have always been a complicated issue and something of a mystery to many, including me. The availability of so many anti-arrhythmic agents to manage this condition means that often pharmacists and junior doctors do not have a clear understanding of when to use which agent, nor do they fully understand the complexities of atrial fibrillation (AF). This book sets out comprehensively the difference between the different classes of agents and when it is appropriate to use them. Drug doses, side effects and evidence for their use are laid out clearly in tables.

As with other books in this series, the structure and layout make it easy to read, with key points highlighted and summarised in text boxes. Diagrams help explain important points clearly and overall it is pleasing to the eye.

The book sets the scene by explaining the importance of treating AF and goes on to look at causes, clinical features and investigations. It discusses both non-drug and drug management and where possible supports the use of either therapy with an evidence base. Further reading is given at the end of each chapter.

Any text on the management of AF would not be complete without discussing anticoagulation. There is a good chapter on this subject, detailing those in whom anticoagulation should be considered and the evidence for it. It does, however, refer to the use of unfractionated heparin for immediate anticoagulation. It would have been helpful to read more on the use of low molecular weight heparins (LMWH). LMWH may not be licensed for this purpose but they are increasingly being used and further information on this would be welcome.

Overall this is a clear and concise text, useful for students and practitioners — a valuable resource on the management of AF.

Janet Lock