Recent developments in atrial fibrillation

doi:10.1136/bmj.330.7485.238

BMJ 2005;330:238-243 (29 January), doi:10.1136/bmj.330.7485.238

Clinical review

Recent developments in atrial fibrillation

M Bilal Iqbal, senior house officer, cardiology¹, Anil K Taneja, senior clinical research fellow, cardiology¹, Gregory Y H Lip, professor of cardiovascular medicine², Marcus Flather, director¹

¹ Clinical Trials and Evaluation Unit, Royal Brompton Hospital, London SW3 6NP, ² University Department of Medicine, City Hospital, Birmingham B18 7QH

Correspondence to: A K Taneja a.taneja@rbh.nthames.nhs.uk

The first 150 words of the full text of this article appear below.

Introduction

Atrial fibrillation, the most commonly encountered arrhythmiain clinical practice, is associated with substantial morbidityand mortality. Its incidence and prevalence are increasing,and it represents a growing clinical and economic burden. Recentresearch has highlighted new approaches to both pharmacologicaland non-pharmacological management strategies. Clinicians needto have a sound working knowledge of atrial fibrillation andto be up to date with the emerging evidence to guide treatmentand improve outcomes in these patients.

Sources and selection criteria

In this article, we highlight the recent advances in atrialfibrillation. We searched PubMed/Medline, Embase, and Cochranedatabases by using the keywords "atrial fibrillation," "rate,""rhythm," "anticoagulation," and "non-pharmacological." We alsosearched references of recent major articles and key reviews,and we obtained articles where necessary.

Epidemiology

Atrial fibrillation affects an estimated 2.2 million adultsin the United States.¹ In the United Kingdom alone, more than46 000 new cases of atrial fibrillation are diagnosed every. . . [Full text of this article]

Classification

Pathophysiology

Cardioversion to sinus rhythm

Pharmacological cardioversion
Electrical cardioversion
Maintenance of sinus rhythm

Ventricular rate control

Reduction of thromboembolic risk

Other new drugs in atrial fibrillation

Non-pharmacological therapy

Radiofrequency catheter ablation
The surgical maze procedure
Implantable atrial defibrillators
Pacing for atrial fibrillation
Ablate and pace
Obliteration of the left atrial appendage

Conclusion

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