Contemporary management of atrial fibrillation

Abstract

Atrial fibrillation is responsible for considerable morbidity in our population. Management of persistent atrial fibrillation of acute onset involves electrical or pharmacological cardioversion to restore sinus rhythm and the use of antiarrhythmic drugs to maintain sinus rhythm. The duration of atrial fibrillation is an important determinant of the timing and success of cardioversion and the risk of embolic complications. When sinus rhythm cannot be maintained, control of ventricular rate and the prevention of stroke become the goals. This is also the case in patients in whom conversion to sinus rhythm is impractical or likely to be unsuccessful. The choice of aspirin or warfarin depends on each patient's individual risk of stroke.