Peer Reviewed
Feature Article Cardiovascular medicine

Atrial fibrillation: beyond drug therapies

Malcolm Anastasius, Maros Elsik
Abstract
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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