Pharmacologic and Non-Pharmacologic Treatment of Chronic Atrial Fibrillation – With Special Reference to Valvular Atrial Fibrillation in Rheumatic Heart Disease

Atrial fibrillation (AF), the most commonly encountered arrhythmia in clinical practice, is associated with significant morbidity and mortality. Of great significance are heart failure and stroke.1 With increased incidence and prevalence of AF, it represents a growing clinical and economic burden. AF is also a progressive disease secondary to continuous structural remodeling of the atria because of AF itself, to changes associated with ageing and to deterioration of underlying heart disease. Current management aims at preventing the recurrence of AF and its consequences and includes risk assessment and prevention of stroke, control of ventricular rate and rhythm control therapies including antiarrhythmic drugs and catheter or surgical ablation.