Atrial fibrillation: goals of therapy and management strategies to achieve the goals.

The primary goals in the management of patients who have atrial fibrillation are prevention of stroke and cardiomyopathy and amelioration of symptoms. Each patient presents to a physician with a specific constellation of symptoms and signs, but, fortunately, most patients can be assigned to broad categories of therapy. For some, anticoagulation and rate control suffice, whereas others require more aggressive attempts to restore and maintain sinus rhythm. Physicians and patients need to be willing to alter therapeutic plans if an initial strategy of rate or rhythm control is unsuccessful.