Management of Atrial Fibrillation

• Published in: Journal of intensive care medicine 2015-12, Vol.30 (8), p.484-498
• Main Authors: Zamani, Payman, Verdino, Ralph J.
• Format: Article
• Language: English
• Subjects: Anti-Arrhythmia Agents - therapeutic use; Atrial Fibrillation - complications; Atrial Fibrillation - physiopathology; Atrial Fibrillation - therapy; Calcium Channel Blockers - therapeutic use; Catheter Ablation; Electric Countershock; Humans; Practice Guidelines as Topic; Prognosis; Stroke - etiology; Stroke - physiopathology; Stroke - prevention & control
• ISSN: 0885-0666; 1525-1489
• DOI: 10.1177/0885066614534603

Atrial fibrillation remains the most prevalent cardiac arrhythmia, and its incidence is increasing as the population ages. Common conditions associated with an increased incidence include advanced age, hypertension, heart failure, and valvular heart disease. Patients with atrial fibrillation may complain of palpitations, fatigue, and decreased exercise tolerance or may be completely asymptomatic. Options for treating patients who experience atrial fibrillation include rate-controlling drugs such as digoxin, β-blockers, and calcium channel blockers or a rhythm-controlling strategy with agents such as sodium channel blockers and potassium channel blockers. Atrial fibrillation increases the risk of stroke due to atrial thrombus formation and embolization. Anticoagulation with the vitamin K antagonist, warfarin, remains the most widely prescribed treatment option to decrease stroke risk. Several other antithrombotic agents have recently become available and offer excellent alternatives to warfarin. Catheter ablation can be undertaken as a nonpharmacologic rhythm control option with varying degrees of success depending on duration of atrial fibrillation and follow-up time from the procedure. This review article further describes the management options for patients presenting with atrial fibrillation.