Atrial fibrillation: a practical review and approach

ABOU CHAKRA L, ABOU JAOUDE S, SALAMEH E. Atrial fibrillation: A practical review and approach. Med Emergency, MJEM 2016; 24:11-6.

Keywords: atrial fibrillation, antithrombotic therapy, early therapy, management, outcomes, rate control, rhythm control, risk factors
  • Authors’ affiliation
  • Article history / info
  • Conflict of interest statement
Correspondent author: Salameh Elie, MD

Division of Cardiology, Hotel-Dieu de France Hospital

Naccache Avenue, Achrafieh, Beirut, Lebanon

etsalame@hotmail.com

Abou Chakra L, MD, Abou Jaoude S, MD, Salameh E, MD

Division of Cardiology, Hotel-Dieu de France Hospital, Naccache Avenue, Achrafieh, Beirut, Lebanon.

Category: Review article

Received: Dec. 16, 2015

Revised: Jan. 20, 2016

Accepted: Feb. 10, 2016

There is no conflict of interest to declare

ABSTRACT

Atrial fibrillation (AF) is a global health problem. The condition brings an increased risk of stroke, systemic embolism, and heart failure and is associated with impaired quality of life, frequent hospitalizations, and mortality. Prevention of AF-related complications relies on antithrombotic therapy, control of ventricular rate, and adequate therapy of concomitant cardiac diseases. Long-term antithrombotic therapy should be guided by the patient’s risk for thromboembolism, after an evaluation of the bleeding risk, and a discussion of the pros and cons and the patient preferences. Symptoms related to AF are an important determinant in making the decision to opt for rate- or rhythm-control in addition to factors that may influence the success of rhythm control. Therefore, setting a successful patient-tailored therapeutic strategy can be a challenging goal to achieve. This review provides a comprehensive overview of the management of atrial fibrillation in the light of the latest 2014 American Heart Association/American College of Cardiology/Heart Rhythm Society guidelines and the 2012 focused update of the European Society of Cardiology guidelines.

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