La fibrillation atriale en 2025 : diagnostic et prise en charge

Abstract

Atrial fibrillation (AF) is the most common arrhythmia. It increases the risk of hospitalization, heart failure, cognitive decline and mortality. It is the first cause of ischemic stroke. These are largely preventable if AF is diagnosed. It is essential to estimate the patient's embolic risk using the CHA2DS2-VA score, which now replaces the CHADS-Vasc score. Patients who require it must receive adequate anticoagulant treatment. New technologies (in particular, smart-watch) have led to advances in the detection and diagnosis of this arrhythmia. Patients suffering from AF may be treated with a heart rate control strategy (to limit tachycardia) or a rhythm control strategy (to maintain sinus rhythm). Catheter ablation is increasingly being offered to patients as an alternative to antiarrhythmic therapy. Controlling risk factors is essential to prevent the onset of AF, and to try to maintain sinus rhythm over the long term.