Rhythm control management in atrial fibrillation
Keywords:
atrial fibrillation, rhythm control, cardioversion, catheter ablationAbstract
Atrial fibrillation (AF) is the most common arrhythmia and causes a high burden on public health. One of the most important treatments is rhythm control. Emergency electrical cardioversion must be performed in hemodynamically unstable patients. While in stable patients, the duration of AF, anticoagulant status, and the risk factors of ischemic stroke should be considered. Transesophageal echocardiography should be performed in selected patients without therapeutic anticoagulants before cardioversion. The long-term rhythm management should be discussed with all patients. Therapeutic options, including antiarrhythmic drugs, catheter ablation, surgery, and hybrid ablation/surgical procedures, should be provided to all patients. Therefore, patients could receive appropriate treatment, according to the indications, clinical status, and preference. Long-term follow-up is one of the main issues in monitoring cardiac rhythm, the decision to continue oral anticoagulant, side effects of antiarrhythmic drugs, and modifying risk factors and comorbidities.
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