The Knowledge about Heart Arrhythmia Type Atrial Fibrillation

Abstract

Pharmacologic management of newly detected atrial fibrillation recommends rate control in preference to rhythm control for the majority of patients who have atrial fibrillation. Preferred options for rate-control therapy include non-dihydropyridine calcium channel blockers and beta-blockers. Rhythm control may be considered for certain patients based on patient symptoms, exercise tolerance, and patient preferences. Recommends lenient rate control (< 110 beats per minute resting) over strict rate control (< 80 beats per minute resting) for patients who have atrial fibrillation. Clinicians discuss the risk of stroke and bleeding with all patients considering anticoagulation. Clinicians should consider using the continuous CHADS2 or continuous CHA2DS2-VASc for prediction of risk of stroke and HAS-BLED for prediction of risk for bleeding in patients who have atrial fibrillation. Recommends that patients who have atrial fibrillation receive chronic anticoagulation unless they are at low risk of stroke (CHADS2 < 2) or have specific contraindications. Choice for anticoagulation therapy should be based on patient preferences and patient history. Options for anticoagulation therapy may include warfarin, apixaban, dabigatran, edoxaban, or rivaroxaban. Recommendation: against dual treatment with anticoagulant and antiplatelet therapy in most patients who have atrial fibrillation.