Management of Atrial Fibrillation

Atrial fibrillation (AF) is the most common heart rhythm problem and a leading cause of morbidity and mortality. Serious complications associated with this disorder include cardioembolic stroke, heart failure, and death. The worldwide prevalence of AF is rapidly increasing owing to aging of the population. Abnormal impulse formation in the pulmonary veins is known to trigger paroxysmal AF and radiofrequency isolation of these veins is recommended in drug-refractory AF. Active pharmacological research is directed towards selectively targeting the culprit venous cells. Persistent AF is more likely to be an atrial disease. Intrinsic and extrinsic stressors are believed to cause electrostructural alterations in the atrial tissue leading to profibrillatory state. Further research will elucidate the role of stressors and help develop biomarkers to guide early management of AF. An ideal therapy for AF aims at prevention of onset and progression of AF and reduction of AF-related symptoms, hospitalization, stroke, and mortality. [Discovery Medicine 10(52): 201-208, September 2010]