Atrial fibrillation:: rate or rhythm control -: individual patient management

The treatment of atrial fibrillation still remains challenging in everyday practice. Even after the introduction of catheter ablation, the decision-making process about the type of therapy became more complex. The recently published guidelines of the American Heart Association, the American College of Cardiology, and the European Society of Cardiology clearly show therapeutic approaches for different types of atrial fibrillation. The fear of thromboembolism still forces the physician to restore sinus rhythm and achieve optimized anticoagulation. Based on large studies, we are able to decide for each patient individually whether oral anticoagulation or ASA is required. Future studies in a large cohort of patients are still necessary to clarify the value of interventional therapy in conjunction with antiarrhythmic drug therapy. These will provide patients with safe therapy and high quality of life despite presenting paroxysmal or persistent atrial fibrillation.