PHARMACOLOGICAL MANAGEMENT OF ATRIAL-FIBRILLATION

Pharmacologic Management of AF. In an era when many electrophysiologic problems are routinely with invasive procedures or implantable device s, drugs remain the cornerstones of treatment for atrial fibrillation. Atrial fibrillation may present as an episodic rhythm in patients who are primarily in sinus rhythm or it may be manifested as rhythm disor der that is permanent. Patients who appear to have an episodic rhythm disorder may be found to be in atrial fibrillation permanently when fo llowed for long periods of time, and prognosis in the two forms is sim ilar. It is, therefore, useful to consider them different manifestatio ns in the same spectrum of disease. This review will address pharmacol ogic approaches designed to: (1) slow ventricular response; (2) restor e sinus rhythm; (3) reduce occurrences of atrial fibrillation; and (4) prevent thromboembolic complications. Nonpharmacologic approaches to treating atrial fibrillation will be briefly reviewed.