Anti-arrhythmic drugs in atrial fibrillation: tailor-made treatments

During the last decades, many improvements have been made regarding the treatment of atrial fibrillation in terms of risk prevention, anti-coagulation strategies, and gain in quality of life. Among those, anti-arrhythmic drugs (AADs) have progressively fallen behind and overtaken by technological aspects as devices as procedures are now the standards of care for many patients. But is this it? Are AADs doomed to be relegated to an obscure and rarely read paragraph of the European recommendations? Or could they be still employed safely and effectively? In the present paper, we will discuss contemporary evidence in order to define where AADs still play a pivotal role, how should AADs be used, and whether a tailored approach can be the way to propose the right treatment to the right patient.

Automated summary

In recent decades, the treatment of atrial fibrillation has seen significant advancements in risk prevention, anti-coagulation strategies, and improvement of quality of life. However, anti-arrhythmic drugs have been overshadowed by technological advancements, such as devices and procedures, which have become the standard of care for many patients. This paper discusses the current evidence to determine the remaining role of anti-arrhythmic drugs, their proper usage, and the potential for a personalized approach in treatment.