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Epidemiology, diagnosis, and treatment of atrial fibrillation: Where are we and where are we going?

Abstract:

Atrial fibrillation is the most common clinically managed supraventricular tachyarrhythmia; it is characterized by irregular contraction of the atria due to multiple local foci of depolarization, which generate a mechanical dissocia-quality of life, increases the risk of thromboembolism and cardiovascular mortality, making it a global public health problem. It is clinically characterized by a pulse deficit, with a definitive diagnosis by 12-lead electrocardiogram and finding P-wave absence, irregular atrial activity, and irregular RR intervals. Within therapeutic management, there are several options depending on the clinical scenario, such as rate control therapy, rhythm control (electrical or pharmacological cardioversion), catheter ablation, pharmacological anticoagulation or occlusion of the left atrium appendix. Many advances have been made in recent decades that have allowed us to approach the etio-pathogenic mechanisms behind this disease, in addition to significantly reducing the impact on quality of life and morbidity and mortality with current therapeutic schemes. However, knowledge gaps have also been found, and further research is necessary. This review presents the current knowledge of atrial fibrillation and the diagnostic and therapeutic perspectives.