[General therapeutic strategy for atrial fibrillation]

Abstract

There are two principles in therapeutic strategy for atrial fibrillation (AF). One is the preventive strategy for thromboembolic events associated with AF. Usefulness of warfarin has been established in various large clinical trials. However, the introduction of new anticoagulant agents, such as dabigatran and rivaroxaban, has given not only much benefits but some confusion in choice of these agents in real clinical situations. Remaining one is intervention to rhythm management, such as "rhythm control" or "rate control". AFFIRM study denied the predominancy of "rhythm control" in management of patients with AF. On the other hand, the indication of catheter ablation for AF, which is the potential tactic for "rhythm control", has been extended. So, general therapeutic strategy for AF has been still obscure.