Atrial fibrillation.

The anatomy, mechanism, presentation and prevalence of atrial fibrillation are now relatively well-established. The arrhythmia can be categorized in many ways, although for the clinician, the grouping into paroxysmal, persistent and permanent has many attractions. For each of these categories, a management strategy is becoming clearer, although there are still considerable deficiencies in our knowledge, particularly in such areas as optimized rate control, medical cardioversion and the use of AV node ablation. These are being addressed by ongoing studies. With their results, we will be closed to an ideal management strategy that will offer the best of rhythm management and the greatest protection from thromboembolism.