RT Book, Section A1 Curtis, Anne B. A1 Baykaner, Tina A1 Narayan, Sanjiv M. A2 Fuster, Valentin A2 Narula, Jagat A2 Vaishnava, Prashant A2 Leon, Martin B. A2 Callans, David J. A2 Rumsfeld, John A2 Poppas, Athena SR Print(0) ID 1191374940 T1 Atrial Fibrillation and Atrial Flutter T2 Fuster and Hurst's The Heart, 15e YR 2022 FD 2022 PB McGraw-Hill Education PP New York, NY SN 9781264257560 LK accesscardiology.mhmedical.com/content.aspx?aid=1191374940 RD 2023/02/07 AB Chapter SummaryThis chapter discusses the epidemiology, pathophysiology, and classification of atrial fibrillation (AF) and atrial flutter, as well as the clinical presentation, evaluation, and management of patients with these arrhythmias (see Fuster and Hurst’s Central Illustration). Patients may have a range of presentations from asymptomatic, with the arrhythmia detected only by electrocardiography or other monitoring, to highly symptomatic. Management approaches should be individualized to patient symptoms and comorbidities. Management of AF may require cardioversion acutely for symptomatic patients, followed by strategies to prevent recurrent AF and minimize sequelae such as stroke. An important consideration in the management of AF is lifestyle modification, because conditions such as sleep apnea, obesity, excessive alcohol intake, and lack of exercise may contribute to the development or maintenance of AF. Long-term management includes anticoagulation for the prevention of thromboembolism in patients deemed to be high risk. The other pillars of management of AF are rate control and rhythm control. Emerging data support early rhythm control by antiarrhythmic drugs or catheter ablation, especially in certain subpopulations such as those with concurrent heart failure. The management of atrial flutter is analogous in most respects to that of AF, although typical atrial flutter is curative in most cases with catheter ablation.