Drug Therapy for the Management of Atrial Fibrillation: An Update

Andrew RJ Mitchell


Br J Cardiol. 2003;10(5) 

In This Article


Drug therapy for the management of AF should be patient-tailored. In the asymptomatic elderly patient with AF, both rate control and rhythm control appear to be acceptable strategies providing that anticoagulation is continued. Digoxin has little effect at controlling the ventricular rate in active patients with permanent AF. Patients undergoing cardioversion of persistent AF should be pre-treated with anti-arrhythmic drugs (particularly amiodarone) to facilitate cardioversion and to improve the likelihood of maintaining sinus rhythm at one year. Direct thrombin inhibitors may offer an alternative to warfarin for the long-term anticoagulation of patients with AF.


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