Management of atrial fibrillation and concomitant coronary artery disease

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and associated with significant morbidity and mortality. Coronary artery disease (CAD) frequently coexists with AF, and management of these associated conditions can be challenging. Bleeding risks of different combinations of evidence-based antithrombotic regimes need to be considered and the effects of different medical therapies for AF or CAD may impact on the other condition. This article reviews the current guidance and consensus statements of the ESC on the management of AF and CAD. The principles of AF management in the context of CAD are considered including upstream therapies to prevent AF, early identification, and antithrombotic risk assessment, and symptomatic rate and rhythm control strategies. Specific scenarios and an illustrative case are discussed to highlight clinical relevance.

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