Curr Probl Cardiol. 2011 Mar;36(3):87-120. doi: 10.1016/j.cpcardiol.2011.01.001.
Atrial fibrillation (AF) is the most common cardiac arrhythmia encountered in clinical practice. Although once considered a nuisance arrhythmia, recent clinical trial evidence suggests that the presence of AF is an important independent predictor of mortality and morbidity. The primary goals of AF treatment are relief of symptoms and prevention of stroke. The value of anticoagulation with warfarin has been proven unequivocally. Control of ventricular rate with atrioventricular nodal blocking agents-the so-called rate control strategy-is least cumbersome and sometimes the best approach. By contrast, efforts to restore and maintain sinus rhythm using antiarrhythmic drugs-the rhythm control approach-although tedious, may be ideal in patients who are young or highly symptomatic and in those with new-onset AF. The relative merits of both treatment strategies are discussed in this article, emphasizing the excellent clinical trial data that support each.
心房颤动（AF）是临床实践中最常见的心律失常。尽管曾经被认为是一种令人讨厌的心律失常，但最近的临床试验证据表明，AF 的存在是死亡率和发病率的一个重要独立预测因素。AF 治疗的主要目标是缓解症状和预防中风。华法林抗凝的价值已得到明确证实。使用房室结阻滞剂（所谓的速率控制策略）控制心室率是最不麻烦的，有时也是最好的方法。相比之下，使用抗心律失常药物恢复和维持窦性节律（节律控制方法）虽然繁琐，但在年轻或症状明显的患者以及新发 AF 患者中可能是理想的。本文讨论了这两种治疗策略的相对优点，强调了支持每种策略的出色临床试验数据。
