Peer Reviewed
Feature Article Cardiovascular medicine

Atrial fibrillation: beyond drug therapies

Malcolm Anastasius, Maros Elsik
Atrial fibrillation is the most common, clinically relevant arrhythmia encountered in general practice with treatment options that continue to expand. This article provides a brief overview of the various types of atrial fibrillation and focuses predominantly on the currently available nonpharmacological treatment modalities.
Key Points
  • Atrial fibrillation is the most common clinically relevant arrhythmia, which in most patients originates from abnormal ‘triggers’ within the pulmonary veins.
  • Medical therapy and nonpharmacological approaches are often used together to treat symptoms of arrhythmia and prevent thromboembolic complications.
  • Catheter ablation of atrial fibrillation utilising a pulmonary vein isolation (PVI) is a commonly used and highly effective procedure to treat symptomatic patients, especially if used early.
  • An ablation of the atrioventricular node and a pacemaker insertion can be useful in improving symptoms in patients who remain symptomatic despite all other treatment attempts.
  • Left atrial appendage occlusion devices can be effective in reducing thromboembolic complications if anticoagulation is contraindicated.

    Picture credit: © Kevin A. Somerville.

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