ABSTRACT
Atrial fibrillation (AF) is an increasingly prevalent arrhythmia; its
pathophysiology and progression are well studied. Stroke and bleeding
risk models have been created and validated. Decision tools for stroke
prophylaxis are evolving, with better options at hand. Utilization of
various diagnostic tools offer insight into AF burden and thromboembolic
risk. Rate control, rhythm control, and stroke prophylaxis are the
cornerstones of AF therapy. Although antiarrhythmic drugs are useful, AF
ablation has become a primary therapeutic strategy. Pulmonary vein
isolation is the cornerstone of AF ablation, and methods to improve
ablation safety and efficacy continue to progress. Ablation of
nonpulmonary vein sites is increasingly being recognized as an important
strategy for treating nonparoxysmal AF. Several new ablation techniques
and technologies and stroke prophylaxis are being explored. This is a
contemporary review on the prevalence, pathophysiology, risk prediction,
prophylaxis, treatment options, new insights for optimizing treatment
outcomes, and emerging concepts of AF.