n CME : Your SA Journal of CPD - Management of atrial fibrillation : main article




AF is a common irregular narrow-complex supraventricular tachyarrhythmia. <BR>AF is often associated with an underlying condition which frequently can be diagnosed after a basic history and physical examination. <BR>In newly diagnosed AF without an obvious underlying cause minimum investigations include a blood count, serum electrolytes, thyroid function, chest X-ray and an echocardiogram. <BR>AF is associated with increased morbidity and mortality related to its rate-related impact on left ventricular function and its association with thromboembolism. <BR>Management of AF is determined by symptoms, ventricular rate and thromboembolic risk and is individualised to each patient. <BR>Drug therapy remains the mainstay of treatment and beta-blockers are still first-line therapy due to proven safety and efficacy. <BR>AV nodal ablation and pacemaker implant is indicated in older patients with intractable symptoms or poor rate control who have failed or are intolerant of medical therapy. <BR>Catheter ablation of AF (without requirement for a pacemaker) is now an additional therapeutic option with an excellent efficacy and safety profile particularly indicated for young patients who have failed or are intolerant of medical therapy.


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