Peer Reviewed
Feature Article Heart diseases

Current management of atrial fibrillation

David Gallagher
An updated version is available in the linked supplement
Abstract

Rate control plus anticoagulation is the usual therapy for atrial fibrillation. A rhythm control strategy has not been shown to have prognostic benefits over rate control with anticoagulation but is useful for symptom management.

Key Points
    • Most patients with atrial fibrillation are elderly or have hypertension and are at high risk of cardiac embolism.
    • The goals of management include control of symptoms, preservation of left ventricular function and prevention of cardiac embolism.
    • Rate control and anticoagulant therapy can be initiated in stable patients by the GP while awaiting specialist review.
    • Anticoagulation is underutilised in high risk groups.
    • A patient’s therapy should be re-evaluated over time because both the risk of embolism and the incidence of conduction disease increase with age.
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