Atrial fibrillation

Lancet. 2012 Feb 18;379(9816):648-61. doi: 10.1016/S0140-6736(11)61514-6. Epub 2011 Dec 11.


The management of atrial fibrillation has evolved greatly in the past few years, and many areas have had substantial advances or developments. Recognition of the limitations of aspirin and the availability of new oral anticoagulant drugs that overcome the inherent drawbacks associated with warfarin will enable widespread application of effective thromboprophylaxis with oral anticoagulants. The emphasis on stroke risk stratification has shifted towards identification of so-called truly low-risk patients with atrial fibrillation who do not need antithrombotic therapy, whereas oral anticoagulation therapy should be considered in patients with one or more risk factors for stroke. New antiarrhythmic drugs, such as dronedarone and vernakalant, have provided some additional opportunities for rhythm control in atrial fibrillation. However, the management of the disorder is increasingly driven by symptoms. The availability of non-pharmacological approaches, such as ablation, has allowed additional options for the management of atrial fibrillation in patients who are unsuitable for or intolerant of drug approaches.

Publication types

  • Review

MeSH terms

  • Administration, Oral
  • Algorithms
  • Anti-Arrhythmia Agents / administration & dosage
  • Anti-Arrhythmia Agents / adverse effects
  • Anti-Arrhythmia Agents / therapeutic use*
  • Anticoagulants / administration & dosage
  • Anticoagulants / adverse effects
  • Anticoagulants / therapeutic use*
  • Aspirin / therapeutic use
  • Atrial Fibrillation / complications*
  • Atrial Fibrillation / diagnosis
  • Atrial Fibrillation / drug therapy
  • Atrial Fibrillation / therapy*
  • Cardiac Pacing, Artificial
  • Cardiovascular Agents / therapeutic use
  • Catheter Ablation
  • Decision Trees
  • Electric Countershock
  • Humans
  • Patient-Centered Care
  • Risk Factors
  • Stroke / etiology
  • Stroke / prevention & control*
  • Warfarin / therapeutic use


  • Anti-Arrhythmia Agents
  • Anticoagulants
  • Cardiovascular Agents
  • Warfarin
  • Aspirin