Kunal Pradip Verma1, Michael Wong2. 1. MBBS, FRACP, Senior Cardiology Advanced Trainee, Department of Cardiology, Eastern Health, Vic. 2. MBBS, Grad Dip (Cardiac EP), PhD, FRACP, Cardiologist and Electrophysiologist, Department of Cardiology, Eastern Health, Vic; Director of Cardiac Electrophysiology, Western Health, Vic; Cardiologist and Electrophysiologist, Epworth Healthcare, Vic. drmichaelwong@live.com.
Abstract
BACKGROUND: Atrial fibrillation (AF) is increasingly common among Australia's ageing population and carries significant morbidity and mortality. Its detection through screening, cardiac device interrogation and/or symptoms of AF brings with it a number of significant clinical issues. OBJECTIVE: The aim of this article is to outline a systematic approach to the management of patients with AF, including the initial investigations required, rhythm versus rate control, anticoagulation for stroke prevention, and the interplay between AF and heart failure. DISCUSSION: Most patients with AF can be managed safely and effectively in the primary care setting. Rhythm control is pursued early in certain patients with AF who are at risk of decompensated heart failure. Specialist cardiology input is important in the treatment of AF coinciding with clinical heart failure, and for patients with medically refractory symptoms or slow/rapid heart rates.
BACKGROUND:Atrial fibrillation (AF) is increasingly common among Australia's ageing population and carries significant morbidity and mortality. Its detection through screening, cardiac device interrogation and/or symptoms of AF brings with it a number of significant clinical issues. OBJECTIVE: The aim of this article is to outline a systematic approach to the management of patients with AF, including the initial investigations required, rhythm versus rate control, anticoagulation for stroke prevention, and the interplay between AF and heart failure. DISCUSSION: Most patients with AF can be managed safely and effectively in the primary care setting. Rhythm control is pursued early in certain patients with AF who are at risk of decompensated heart failure. Specialist cardiology input is important in the treatment of AF coinciding with clinical heart failure, and for patients with medically refractory symptoms or slow/rapid heart rates.