[Antiarrhythmic drugs will no longer be of importance in the treatment of atrial fibrillation in the future : Pros and cons].

Abstract

An early rhythm stabilization is the primary focus of the current treatment of atrial fibrillation. Based on current studies catheter ablation of pulmonary vein isolation (PVI) is an established component in the treatment of atrial fibrillation. Therefore, in the management of affected patients this procedure should be offered at an early stage in addition to the holistic treatment approach with consistent treatment of cardiovascular risk factors and thromboembolism prophylaxis with anticoagulants. Substances with an antiarrhythmic effect can be included in a supportive role in the management of atrial fibrillation. Pharmacotherapy could also perspectively play an important role in the treatment of the underlying atrial cardiomyopathy of the phenotype of atrial fibrillation. An understanding of the atrial pathophysiology of individual patients with adapted selection of suitable treatment strategies of ablation up to pharmacotherapy is decisive for the successful antiarrhythmic outcome. The decision on the treatment strategy must always be individually made together with the affected patient. The advantages and disadvantages of both options must be explained in detail and pre-existing comorbidities and risk factors must be included. Additionally, the individual wishes of the patient must be taken into account.