Atrial fibrillation or AF is a common condition that can affect upto 10% of the population above the age of 80. It is more common with age. Patients can present with a wide range of symptoms from --no symptoms to shortness of breath and chest pain with or without palpitations.
There are two important things to consider when someone is in AF.
1.Should you try to convert the rhythm back to a normal rhythm--or simply control the rate of the heart beat?
In patients who have recently gone into AF conversion back to a normal rhythm may be appropriate especially when they have symptoms associated with AF. This can either be done with electrical DC cardioversion or with medication such as sotalol, amiodarone or flecainide.
In selected patients who are particularly symptomatic a procedure called AF ablation may be appropriate.
2. Does the patient need to be on blood thinners (anticoagulation) to reduce the risk of stroke?
Stroke prevention is a major consideration as being in AF is a risk factor for strokes in some patients. This can either be with simply aspirin, or warfarin or in some suitable patients, newer oral anticoagulants such as Dabigatran.
AF is a common condition and the treatment involves both short term symptom control and the risk assessment of strokes.