Gabriela Kaliská, Adrián Bystriansky, Ivan Rybár, Martin Škamla
Atrial fibrillation is the most common persistent heart rhythm disorder. Accepted treatment strategies repose on evidence based medicine and clinical experience. They include conversion of paroxysmal and persistent forms of atrial fibrillation and preserving of the sinus rhythm, as well as accepting atrial fibrillation and controlling the ventricular rate. With any of the two strategies attention must be paid to prevention of embolic complications caused by thrombotic material from the atria. It has been proven by results of registries and particularly specially designed randomized studies that both strategies have a comparable effect on the mortality. Physical performance, functional class and quality of life are better when applying rhythm control. Rhythm control is the best treatment strategy in younger patients with less frequent paroxysms of atrial fibrillation and in symptomatic patients. Evidence showing that the benefits of rate control are equal to those of rhythm control is sparse in the age category under 65 years. Therefore, rate control is accepted as an appropriate treatment strategy in elderly, in patients with frequent episodes of atrial fibrillation and minimally symptomatic patients.