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Atrial Fibrillation
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Abstract
Atrial fibrillation (AF) is an increasingly prevalent arrhythmia; its pathophysiology
and progression are well studied. Stroke and bleeding risk models have been created
and validated. Decision tools for stroke prophylaxis are evolving, with better options
at hand. Utilization of various diagnostic tools offer insight into AF burden and
thromboembolic risk. Rate control, rhythm control, and stroke prophylaxis are the
cornerstones of AF therapy. Although antiarrhythmic drugs are useful, AF ablation
has become a primary therapeutic strategy. Pulmonary vein isolation is the cornerstone
of AF ablation, and methods to improve ablation safety and efficacy continue to progress.
Ablation of nonpulmonary vein sites is increasingly being recognized as an important
strategy for treating nonparoxysmal AF. Several new ablation techniques and technologies
and stroke prophylaxis are being explored. This is a contemporary review on the prevalence,
pathophysiology, risk prediction, prophylaxis, treatment options, new insights for
optimizing treatment outcomes, and emerging concepts of AF.