Management of atrial fibrillation.

BACKGROUND

Atrial fibrillation affects a significant proportion of the Australian population, affecting approximately 5% of people over 65 years of age.

OBJECTIVE

This article provides an approach to the management of this common arrhythmia.

DISCUSSION

During initial assessment, it is important to identify and treat any comorbid conditions that may contribute to atrial fibrillation. The clinician must then determine an appropriate anticoagulation regimen and choice of either a rate or rhythm control approach. Anticoagulation can be with either warfarin or aspirin, with the decision based on an assessment of the patient's thromboembolic risk. Rate and/or rhythm control can be achieved pharmacologically, with device based therapy or with newer catheter ablation techniques. A combination of these differing approaches may be required in patients in whom it is difficult to achieve and maintain therapeutic goals.