Update on medical management of atrial fibrillation in the modern era.

The management of atrial fibrillation involves control of the ventricular response rate, anticoagulation to reduce the risk of stroke and attempts to maintain sinus rhythm. The approach to patients with atrial fibrillation has become increasingly complex as therapeutic options have expanded. The ultimate reasons to treat atrial fibrillation include improvement in symptoms, reduction in adverse outcomes and improvement in survival. Despite increasing interest in non pharmacological approaches to treat and potentially cure atrial fibrillation, drugs remain the primary method to treat most patients. This review updates the present state-of-the-art regarding medical management of atrial fibrillation based on present and emerging evidence.