Annals of Internal Medicine tip sheet December 16, 2003

December 15, 2003

Two Largest Primary Care Medical Organizations Release Joint Clinical Guidelines To Manage Common Heart Condition
The American Academy of Family Physicians and the American College of Physicians released joint guidelines to manage new-onset atrial fibrillation, a common arrhythmia (irregular heartbeat) that occurs most often in older adults (Guidelines, pp. 1009-1017; Background Evidence Paper, pp. 1018-1033). According to the new guidelines, control of heart rate (not heart rhythm) with chronic anticoagulation medication is the recommended strategy for the majority of patients with atrial fibrillation. The guidelines identify drugs recommended for controlling heart rate during exercise and at rest.

Atrial fibrillation is an abnormal heart rhythm in which the upper heart chambers (atria) contract rapidly, pumping blood inefficiently. The condition is rarely fatal, but, if uncontrolled, can cause stroke when blood clots, formed in the atria, travel to the brain. Standard treatments have attempted to convert the heart to normal rhythm, either with medications or electricity, and often use long-term medication to try to maintain the normal rhythm.

The guidelines are the result of an 18-month collaboration between the two organizations to develop evidence-based recommendations on the best way to treat atrial fibrillation.

(Call for separate news release.)

Review: Sunscreen Not Linked to Melanoma Risk

A few reports have suggested that sunscreen use may increase rather than decrease risk for melanoma, a skin cancer that is increasing faster than any other cancer in the United States. Researchers reviewed 18 studies on melanoma and sunscreen use and found that sunscreen was not linked to melanoma risk (Article, p. 966). Some of the studies did not account for the possibility that people with a higher risk for melanoma might use sunscreens more often. Others were older and did not contain data about newer sunscreens with SPFs greater than 15, protection against ultraviolet A radiation, and/or water resistance. The authors say their new analysis found a few studies in which sunscreen was associated with protection from melanoma.
Annals of Internal Medicine is published by the American College of Physicians, an organization of more than 115,000 internal medicine physicians and medical students. These highlights are not intended to substitute for articles as sources of information. For an embargoed fax of an article, call 1-800-523-1546, ext. 2656, or 215-351-2656.

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