Modern aspects of treatment for patients with atrial fibrillation (a literature review)

Abstract

The aim of the work is to analyze and summarize the data of the scientific literature which highlight modern approaches to the management of patients with atrial fibrillation (AF). In the article, on the basis of the modern literature analysis, the basic therapeutic directions and methods of surgical correction of AF are analyzed. Emphasis is placed on the need to treat AF patients in accordance with the ABC strategy, which includes the prevention of thromboembolic complications (A), control of symptoms (B), as well as treatment of comorbidities and elimination of risk factors (C). The main risk factors for AF, its relationship with other cardiovascular events (including mortality, stroke rate and acute coronary syndrome) are analyzed, the main scales used to objectively assess the risks of AF are determined, and detailed analysis of different strategies for anticoagulant therapy is conducted. The main approaches to the control of symptoms by regulating the frequency of ventricular rhythm, restoration and maintenance of sinus rhythm with the use of cardioversion, the administration of antiarrhythmic peptide and catheter ablation are considered. In addition, attention is paid to the need to identify and treat comorbidities, cardiometabolic risk factors and lifestyle, which complement stroke prevention and reduce the severity of AF and symptoms. Conclusions. A large number of clinical studies is focused on AF, the main idea of which is the integrated management of AF to improve the prognosis and quality of patients’ life. According to current recommendations, treatment of a patient with AF should be consistent and in accordance with the ABC strategy. Taking into account etiological factors, cardiometabolic risk factors, lifestyle, comorbid conditions will allow physicians to timely individualize complex treatment of patients with AF.