Persistent atrial fibrillation with a 45 mm left atrium should be treated formally by controlling the ventricular rate while giving anticoagulation therapy and radiofrequency ablation if necessary.
Persistent atrial fibrillation, if poorly controlled, can lead to further enlargement of the left atrium. Enlargement of the left atrium is also a cause of atrial fibrillation, and the two can influence each other. Patients with persistent atrial fibrillation with left atrial enlargement should be treated with regular oral medications, such as oral metoprolol for ventricular rate control and rivaroxaban for anticoagulation, to prevent the risk of arterial embolism.
In some patients, radiofrequency ablation can be performed to cut off excess conduction pathways and stop the onset of atrial fibrillation.
Patients with persistent atrial fibrillation should be treated regularly under the guidance of a physician to develop an appropriate treatment plan.