Atrial fibrillation

Atrial fibrillation (AF) is the commonest clinical arrhythmia and one that will be faced frequently by doctors throughout their medical career. AF is a significant cause of symptoms, hospitalisation, morbidity and mortality. With an increasing and ageing population, the number of patients being treated with AF continues to rise with enormous demands on healthcare funds and resources. In spite of tremendous advances in cardiovascular medicine over the last century, antiarrhythmic therapy remains only moderately effective at preventing AF, it needs to be patient-tailored and it can be associated with significant side-effects. Additionally, oral anti-thrombotic therapy has barely altered in the last fifty years. New electrophysiological techniques are now allowing patients to be offered ablation therapy to reduce AF onsets with promising results. With the likelihood of new anti-arrhythmics and anti-thrombotic medications on the horizon, perhaps we can be optimistic about the future for the patient with this stubborn condition. This article discusses current aspects of AF diagnosis, clinical management and therapies and examines the role of drug therapy, stroke risk reduction and the use of ablation.