The management of atrial fibrillation: current perspectives.

The management of atrial fibrillation is evolving in response to recently published data. Low-risk patients with new-onset atrial fibrillation may not need to be hospitalized. Beta blockers may be the most effective drugs for controlling the heart rate. When a patient does not respond to drug therapy, it is still appropriate to search for the cause of the arrhythmia and to use direct-current cardioversion. Clear evidence now exists that patients with chronic atrial fibrillation should be given anticoagulant drugs to reduce the risk of stroke. Antiarrhythmic drugs should be used cautiously, because they may cause life-threatening arrhythmias.