Pharmacologic maintenance of sinusal rhythm and/or control of the ventricular response in patients with atrial fibrillation or flutter

Atrial fibrillation is the most common cardiac arrhythmia and is usually responsible for symptoms requiring some treatment. Antiarrhythmic drugs are the first choice therapy, but their potential risks are significant. This together with their limited efficacy restricts their use. Antiarrhythmic drug use should be tailored; mainly according to the underlying heart disease. When reversion to sinus rhythm is not eligible, the adequate control of ventricular rate and the reduction of embolic risk are the therapeutic goals. Atrial flutter shows different behaviour regarding the very limited efficacy of antiarrhythmic drugs for reversion to and maintenance in sinus rhythm.