[Medical treatment of atrial fibrillation in the healthy heart].

Whatever the cause and clinical features, establishing the strategy for the medical treatment of atrial fibrillation, requires three basic steps. First sinus rhythm must be restored, followed by the prescription of antiarrhythmic drugs to prevent recurrence and finally the use of anticoagulants. Obviously the underlying heart disease has a major effect on the patient's tolerance of atrial fibrillation, the risks of peripheral embolism and overall mortality. In patients with "solitary atrial fibrillation" and an apparently normal heart, each step of the treatment must be examined in light of the individual patients clinical situation and the risks of haemorrhage with anticoagulants as well as the risk of lethal ventricular arrhythmia due to the arrhythmogenic effect of class la or 1c antiarrhythmic drugs.