Contemporary management of atrial fibrillation: a brief review

Atrial fibrillation (AF) is the most common cardiac arrhythmia with a prevalence of up to 10% in patients who are 80 years and older. There has been some significant progress in the understanding and management of AF in recent years. Large-scale clinical trials have provided solid evidence in supporting the role of anti-thrombotic therapies in the prevention of stroke in moderate to high risk patients. Appropriate control of the ventricular rate or the maintenance of sinus rhythm offers long-term benefits in specific groups of patients. Catheter ablation or “Maze” surgery has proven to be curative to some patients. However, the implementation of the evidence-based therapeutic strategies in the day-to-day care of the AF patients have been found to vary greatly from one institution to another, some of which are hindering the achievement of optimal long-term outcomes. In this brief review, some of the key strategies in the evidence-based management of AF are discussed, with particular emphasis on anti-thrombotic therapy, rhythm or rate control, as well as catheter ablation.