DOI: 10.36347/sjmcr.2020.v08i12.008

Pages: 1012-1019

Atrial fibrillation is the most common cardiac arrhythmia. It impairs cardiac function and increases the risk of stroke. The incidence of atrial fibrillation increases with age. Key treatment issues include deciding when to restore normal sinus rhythm, when to control rate only, and how to prevent thromboembolism. Rate control is the preferred management option in most patients. Rhythm control is an option for patients in whom rate control cannot be achieved or who have persistent symptoms despite rate control. The current recommendation for strict rate control is a resting heart rate of less than 80 beats per minute. However, one study has shown that more lenient rate control of less than 110 beats per minute while at rest was not inferior to strict rate control in preventing cardiac death, heart failure, stroke, and life-threatening arrhythmias. Anticoagulation therapy is needed with rate control and rhythm control to prevent stroke. Atrial fibrillation prevalence has been on the rise. The risk of stroke is 5-times higher in a patient with known atrial fibrillation compared to the general public. It is estimated that 19.6% of patients over the age of 65 will have apparent atrial fibrillation by 2030. The most feared side effect of atrial fibrillation is an acute stroke, which can lead to severe morbidity and mortality. It has been shown that 60% of strokes secondary to atrial fibrillation can be avoided with the use of anticoagulants. Using the CHADs-2-VASc score to evaluate patients with atrial fibrillation is a helpful guide for the management of these patients with the ultimate goal of preventing stroke. These AF classifications are not mutually exclusive and it is common for patients with one type of AF to exhibit overlapping features of another type. These classifications are relevant clinically with respect to outcomes and prognosis with rhythm-controlling treatment strategies. Atrial fibrillation is commonly associated with other supraventricular arrhythmia