How and when to cardiovert the auricular fibrillation at the begining of the year 2000

The high incidence and associated complications are causing atrial fibrilla tion to emerge as a disease of uncertain prognosis, rather than an acceptab le alternative to sinus rhythm. There is accumulated evidence of an electri cal and anatomical remodelling in atrial fibrillation that facilitates the onset and maintenance of this arrhythmia, and the capacity for these change s may be reversed if sinus rhythm is restored. The development of new drugs that decrease the incidence of recurrences and the advent of internal card ioversion, which has proven to be very effective when traditional methods h ave failed, have widened the indications and increased the number of patien ts who may benefit from this technique, These advances pave the way for the development of an implantable atrial cardioversor, which would allow an ea rly treatment of atrial fibrillation and, therefore, lessen the deleterious effects brought on by this rhythm disorder.