Medications remain an important treatment for AF, restoring and maintaining sinus rhythm, controlling the ventricular rate, and preventing thromboembolic complications. Sinus rhythm restoration (rhythm control) drugs: For new-onset atrial fibrillation, because of the high rate of sinus restoration within 48h (about 60% within 24h), observation can be done first, or propafenone (450mg-600mg) or flecainide (300mg, not available in China) can be administered. If AF has lasted for more than 48h and less than 7 days, intravenous drugs such as flucarbamate, dofetilide, propafenone, ibuprofen and amiodarone can be used to transcend the rhythm, with a success rate of up to 50%. The effectiveness of pharmacologic cardioversion is greatly reduced in atrial fibrillation episodes lasting longer than one week (persistent atrial fibrillation), and commonly used and proven effective drugs include amiodarone, Ibutilide, and dofetilide. Drugs to control the ventricular rate (frequency control): Controlling the ventricular rate ensures the basic function of the heart and minimizes the cardiac dysfunction caused by atrial fibrillation. The rapidity of ventricular rate in atrial fibrillation is related to the atrioventricular node expiration period, sympathetic and parasympathetic tone, and its own conduction properties. Drugs that are effective in prolonging the AV node’s expiration period can effectively control the ventricular rate, such as β-blockers, calcium channel antagonists and digoxin, which can be used alone or in combination to control the ventricular rate in atrial fibrillation. Among them: (1) β-blockers are the most effective, most commonly used and often applied alone, especially in patients with a hyperadrenergic state. (2) Non-dihydropyridine calcium channel antagonists, such as verapamil and diltiazem, are also effective for ventricular rate control in atrial fibrillation, especially for the control of ventricular rate during exercise compared to digoxin, and in combination with digoxin. It is especially used in patients with no organic heart disease or normal left ventricular systolic function and with chronic obstructive pulmonary disease. (3) Digitalis has been considered as the first-line drug to control the ventricular rate of atrial fibrillation in emergency situations, but it is now considered to be less effective than β-blockers and calcium channel antagonists; it is currently used clinically to control the ventricular rate in the presence of left heart failure. (4) Amiodarone can also reduce the ventricular rate in atrial fibrillation because of its beta-blocking effect. It is not recommended for long-term ventricular rate control in chronic atrial fibrillation, but can be preferred in combination with digitalis when other drugs are ineffective or contraindicated, or when atrial fibrillation combined with heart failure requires urgent ventricular rate control. Anticoagulants: Regardless of the method of cardioversion, adequate anticoagulation must be performed for three weeks prior to cardioversion (the first three), and anticoagulation must be continued for at least four weeks after cardioversion (the second four), and the intensity of anticoagulation must be stabilized at INR 2 to 3. Warfarin is the most widely used anticoagulant in clinical practice. However, warfarin application is affected by many factors, such as narrow therapeutic safety window, high risk of bleeding, the need for frequent monitoring, and increased costs, and more optimal thrombin inhibitors are yet to be developed and applied. Antiplatelet therapy can prevent thrombosis, and combined antiplatelet agents such as aspirin and clobigrel also have some application.