Pharmacologic and Nonpharmacologic Management of Atrial Fibrillation

Atrial fibrillation (AF) is the most common arrhythmia and its management may be organized into risk stratification and/or treatment of heart failure, stroke prevention, and symptom control. At the core of symptom control, treatment is tailored to either allow AF continue with controlled heart rates, so-called rate control, versus restoring and maintaining sinus rhythm or rhythm control. Rate control strategies mainly use rate-modulating medications, whereas rhythm control treatment includes therapy aimed at restoring sinus rhythm, including pharmacologic and direct current cardioversion, as well as maintenance of sinus rhythm, including anti-arrhythmic medications and ablation therapy.