title: Management strategies for atrial fibrillation.
abstract: Atrial fibrillation is the most prevalent cardiac arrhythmia, affecting 10% of those aged over 80 years. Despite multiple treatment options, it remains an independent prognostic marker of mortality due to its association with clinical sequelae, particularly cerebrovascular events. Management can be broadly divided into treatment of the arrhythmia, via rhythm or rate control, and stroke thromboprophylaxis via anticoagulation. Traditional options for pharmacotherapy include negatively chronotropic drugs such as β-blockers, and/or arrhythmia-modifying drugs such as amiodarone. More recently, catheter ablation has emerged as a suitable alternative for selected patients. Additionally, there has been extensive research to assess the role of novel oral anticoagulants as alternatives to warfarin therapy. There is mounting evidence to suggest that they provide comparable efficacy, while being associated with lower bleeding complications. While these findings are promising, recent controversies have arisen with the use of novel oral anticoagulants. Further research is warranted to fully elucidate mechanisms and establish antidotes so that treatment options can be appropriately directed.
authors.affiliation: 1 Department of Cardiology, Leeds General Infirmary, Leeds LS1 3EX, UK.
authors.forename: Peysh A
authors.initials: PA
authors.lastname: Patel
authors.affiliation: 2 Department of Cardiology, Bradford Royal Infirmary, Bradford BD9 6RJ, UK.
authors.forename: Noman
authors.initials: N
authors.lastname: Ali
authors.affiliation: 1 Department of Cardiology, Leeds General Infirmary, Leeds LS1 3EX, UK.
authors.forename: Andrew
authors.initials: A
authors.lastname: Hogarth
authors.affiliation: 1 Department of Cardiology, Leeds General Infirmary, Leeds LS1 3EX, UK.
authors.forename: Muzahir H
authors.initials: MH
authors.lastname: Tayebjee
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D001281:Atrial Fibrillation / Q000628:therapy*; D017115:Catheter Ablation; D019468:Disease Management; D006801:Humans
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants
keywords: Atrial fibrillation; arrhythmia-modifying drugs; catheter ablation; novel anticoagulants; warfarin