Evolving concepts in the treatment of atrial fibrillation

Atrial fibrillation (AF) is common among older adults, and its prevalence is increasing due to an aging population. This article reviews the recent insights into the mechanisms of AF, new developments in pharmacologic and nonpharmacologic therapy, and the impact of recent randomized clinical trials in the management of AF. Randomized clinical trials have shown that rhythm control with antiarrhythmic drugs offers no advantage over rate control for the prevention of death and cardiovascular morbidity. Catheter ablation of AF may play an increasingly important role in the future.