Atrial fibrillation is a very common clinical arrhythmia, but the mechanism of atrial fibrillation has not been fully elucidated, and there is still a lot of confusion and even misunderstanding about the treatment of atrial fibrillation. See what experts have to say about how atrial fibrillation can be treated more favorably. Throughout the treatment of atrial fibrillation mainly includes: resetting and maintaining sinus rhythm, controlling ventricular rate and anticoagulation therapy to prevent thromboembolism, prevention of atrial fibrillation, and eradication of atrial fibrillation lesions. Non-pharmacological treatments include radiofrequency ablation, pacemaker therapy, in vivo atrial defibrillator therapy, surgical treatment, and left-ear occlusion. Atrial fibrillation reversal: This can be accomplished by the use of drugs or electric shock methods. Pharmacologic diversion is not as effective as diversion, but electrical diversion requires sedation or anesthesia whereas pharmacologic diversion does not. The main risks of electrical diversion are the development of thrombotic events and arrhythmias. Ventricular rate control: is another effective treatment for AF, especially since the results of the AFFIRM trial showed that resuscitation and maintenance of sinus rhythm were not superior to ventricular rate control in terms of improving patients’ quality of life, number of hospitalizations, and mortality; therefore, ventricular rate control may be the treatment of choice for AF as well as resuscitation. Anticoagulation: It is extremely important for patients with atrial fibrillation who have risk factors for stroke. The results of several large clinical trials have shown that warfarin may benefit patients with atrial fibrillation. However, patients treated with warfarin (especially elderly patients) are at high risk of intracranial hemorrhage, and dose adjustments are complicated and require repeated INR measurements. The recent SPROTIF trial showed that the new oral thrombin inhibitor ximilate (Ximdla-gatran) is similar to warfarin in its anticoagulant effect, but without the above-mentioned disadvantages. In addition, percutaneous left auricular occlusion is a good option for patients with chronic atrial fibrillation who have contraindications to anticoagulation or poor tolerability. Elderly patients with atrial fibrillation have a higher risk of stroke and increased mortality. The characteristics of atrial fibrillation in the elderly and its treatment should be noted. Among the non-pharmacological treatments for atrial fibrillation, the maze procedure (surgical treatment of atrial fibrillation (modified Cox’s maze procedure)) created by Cox et al. has a high success rate in the treatment of atrial fibrillation in selective patients. Simultaneous surgery for atrial fibrillation with surgery for organic heart disease has been successful. In recent years, open-heart surgery has been used to treat valvular, ischemic, or congenital heart disease, and concomitant maze surgery or radiofrequency ablation mimicking maze surgery for atrial fibrillation or atrial flutter should be considered. Transcatheter radiofrequency ablation is one of the hot spots in the treatment of atrial fibrillation today. Radiofrequency ablation treatment includes two major aspects: ablation of modified AV nodes or complete ablation of AV node placement pacemakers to control ventricular rate in atrial fibrillation that is difficult to control with drugs; and intra-atrial linear ablation or ablation of pulmonary veins (including point ablation and circumferential ablation) to prevent recurrence of atrial fibrillation. A study including 1171 patients with atrial fibrillation was published in Europe in recent years. The results showed that patients with atrial fibrillation who underwent pulmonary vein ablation had a mortality rate of 6% compared to 14% in the drug treatment group; the recurrence rate of atrial fibrillation was also significantly lower in the ablation group than in the drug treatment group (20% vs. 58%). This suggests that radiofrequency ablation therapy for atrial fibrillation has a good future. Pacing for atrial fibrillation is also beginning to be used in clinical trials. New pacemakers such as Vitaron’s Selection 900Eg and Medtronic’s AT501 apply various special pacing modes to prevent atrial fibrillation by targeting the factors that trigger atrial prematureness, long and short cycle phenomena, atrial conduction block, and bradycardia, and also by applying techniques such as biventricular or right atrial multi-site pacing. However, its effectiveness needs further validation. Intracorporeal atrial defibrillator (IAD) can be used as a method of atrial fibrillation defibrillation, but it has less clinical application. The current generation of ICDs, which are mainly used in combination with ventricular cardioverter-defibrillators (ICDs), are used to treat patients with both ventricular arrhythmias and atrial fibrillation, as well as for those with infrequent episodes of atrial fibrillation that are not tolerated. Finally, in the prevention of AF, inhibition of the renin-angiotensin system (RAS) may have an important role. The RAS may become a new hot topic in the prevention and treatment of atrial fibrillation, as demonstrated by animal studies that link angiotensin II to atrial fibrosis and the development of atrial fibrillation, and by clinical studies that show that ACE inhibitors and AT1 receptor antagonists may reduce the incidence of atrial fibrillation or increase the success of conversion. Linear ablation of atrial fibrillation: Similar to surgical maze, catheter-based radiofrequency ablation creates several consecutive lines of wall damage in the atria, dividing the atrial tissue into separate electrically functional areas smaller than the critical area needed to cause maintenance of persistent atrial fibrillation, thereby terminating or preventing the recurrence of atrial fibrillation and/or atrial flutter, or improving the sensitivity of drug therapy, as well as reducing the duration and number of episodes of paroxysmal atrial fibrillation or conversion of persistent AF to paroxysmal AF. Pulmonary vein isolation: Most focal atrial fibrillation is related to the electrical activity of the pulmonary veins. Catheter radiofrequency ablation is applied to continuously discharge ablation around the pulmonary vein orifice (junction with the atria) to form a ring injury to eliminate the pulmonary vein potential, or to prevent the pulmonary vein potential from transmitting to the atria and the electrical activity of the atria from transmitting to the pulmonary veins, so as to terminate and prevent paroxysmal atrial fibrillation.