1 Answers
The management of atrial fibrillation is focused on preventing temporary circulatory instability, stroke and other ischemic events. Control of heart rate and rhythm are principally used to achieve the former, while anticoagulation may be employed to decrease the risk of stroke. Within the context of stroke, the discipline may be referred to as stroke prevention in atrial fibrillation. In emergencies, when circulatory collapse is imminent due to uncontrolled rapid heart rate, immediate cardioversion may be indicated.
The primary factors determining AF treatment are duration and evidence of circulatory instability. Cardioversion is indicated with new onset AF and with circulatory instability. If rate and rhythm control cannot be maintained by medication or cardioversion, it may be necessary to perform electrophysiological studies with ablation of abnormal electrical pathways.
Patients can be classified, based on how much they are limited during physical activity, according to the European Heart Rhythm Association score of atrial fibrillation.