Atrial fibrillation. Current recommendations for diagnosis and treatment

Atrial fibrillation (AF) is by far the most common arrhythmia. It occurs more often with increasing age. Patients with AF almost always require oral anticoagulants and a rate-control treatment. In addition, other cardiovascular diseases must also be carefully treated in order to reduce the risks of cardiovascular complications from AF. Most patients profit from rate-control treatment with drugs that slow the conduction of the electrical impulse through the AV node. The aim is a resting heart rate of 100-110/min. If patients suffer from AF whilst on optimal rate control therapy, rhythm-control treatment with antiarrhythmic drugs, cardioversion or catheter ablation is indicated. The choice of the rhythm-control therapy should be made based on safety considerations. Whether achieving sinus rhythm beyond improvement of symptoms improves the prognosis of AF is tested in ongoing trials.