title: Cardiovascular Disease Update: Atrial Fibrillation.
abstract: Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia. The prevalence increases with age, especially in the seventh and eighth decades of life. AF also is associated with multiple risk factors and conditions that are managed commonly in family medicine settings, such as hypertension and diabetes. Rhythm control and rate control are primarily equivalent for mortality rate, but patients treated for rhythm control have more hospitalizations; however, rhythm control may be a viable option for select patients. Beta blockers and nondihydropyridine calcium channel blockers can be used to achieve rate control. Pharmacotherapy or electrical cardioversion can be used to achieve rhythm control, and antiarrhythmic drugs are used to maintain sinus rhythm. Catheter ablation is an option for symptomatic patients whose AF is refractory to standard treatment. The CHA2DS2-VASc score should be used to predict the risk of stroke for patients with AF. Patients with nonvalvular AF and a history of stroke or transient ischemic attack or CHA2DS2-VASc scores of 2 or greater should be treated with warfarin or novel oral anticoagulants. Patients with valvular AF should be treated with warfarin.
authors.affiliation: Naval Hospital Jacksonville, 2080 Child St, Jacksonville, FL 32212.
authors.forename: Johnathan D
authors.initials: JD
authors.lastname: McDivitt
authors.affiliation: Womack Army Medical Center, 2817 Reilly Road, Fort Bragg, NC 28310.
authors.forename: Craig
authors.initials: C
authors.lastname: Barstow
mesh_terms: D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000925:Anticoagulants / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000145:classification / Q000188:drug therapy* / Q000601:surgery*; D017115:Catheter Ablation / Q000379:methods*; D005194:Family Practice; D006801:Humans; D012307:Risk Factors; D020521:Stroke / Q000517:prevention & control
chemical_list: D000889:Anti-Arrhythmia Agents; D000925:Anticoagulants