Newly Discovered AF

Paraxysmal

• these patients do not usu need an aad unless severe symptoms

• if patient is at risk for thromboembolism

Anti coagulate

Newly Discovered Persistent AF

• accept permanent af and focus on rate control and
• anti coagulation

if attempt to restore normal sinus rhythm (cardioversion) is chosen patients first need anti coagulation and rate control and possibly aad therapy

Depends on symptoms

if patients have minimal symptoms, no aads

if patients have troublesome symptoms may need aad for rhythm control... if fails non pharmacologic options such as left atrial ablation may be considered

both get anti coagulation and rate control

Recurrent Persistent AF

NO SYMPTOMS = rate control and ac as needed

Disabling symptoms = anti coagulation, rate control as needed and aad followed by cardioversion

if fails... left atrial ablation, or surgery Maze or av node ablation and pacing may be considered

ac and rate control as needed

for patients for whom rythym restoration