[Atrial fibrillation : An overview of the various treatment options]

Atrial fibrillation is associated with a reduced quality of life, an increased risk of thromboembolic events and higher mortality. A fast and individualized treatment is essential, particularly to positively influence the progression. In addition to risk-adapted oral anticoagulation, early rhythm control is crucial for reducing the burden of symptoms as well as for decreasing hospitalization, ischemic stroke and cardiovascular death. Options for rhythm control include pharmacological strategies, electrical cardioversion, and catheter-based ablation procedures. Electrical cardioversion is particularly suitable for the acute treatment of hemodynamically unstable patients, while pharmacological treatment and catheter ablation represent long-term treatment approaches. Class IC antiarrhythmic drugs such as flecainide and propafenone are contraindicated in patients with structural heart disease.