Atrial Fibrillation: Goals of Therapy and Management Strategies to Achieve the Goals

The primary goals in the management of patients who have atrial fibrillation are prevention of stroke and tachycardia-induced cardiomyopathy and amelioration of symptoms. Each patient presents to a physician with a specific constellation of symptoms and signs, but, fortunately, most patients can be assigned to broad categories for therapy. For some, anticoagulation and rate control suffice, whereas others require attempts to restore and maintain sinus rhythm. Physicians and patients should be willing to alter therapeutic plans if an initial strategy of rate or rhythm control is unsuccessful.