2 Indications and current treatments

Guidance

2.1 Atrial fibrillation (AF) is the most common type of cardiac arrhythmia. It is caused by the uncoordinated electrical stimulation of the atrial walls, which stop contracting as they fibrillate. This causes the ventricle to beat at an irregular and sometimes rapid rate. Patients with AF may be asymptomatic or have palpitations, dizziness, shortness of breath, fatigue and chest pain.

2.2 AF is associated with increased risk of embolic stroke from atrial thrombus, and death. Depending on risk stratification, oral anticoagulation treatment may be indicated. Such treatment is associated with risk of haemorrhage and requires long‑term follow‑up. Drugs may be used to prevent AF and maintain sinus rhythm (anti‑arrhythmics) or may be used to control the ventricular rate when AF occurs (usually beta blockers).

2.3 Ablation procedures are typically done in patients with non‑permanent AF when drug therapy is either not tolerated or is ineffective.