Antiarrhythmic Drugs for Rhythm Control of Atrial Fibrillation: Unmet Needs and Future Directions

Tremendous progress has been made in the knowledge of the pathophysiology of atrial fibrillation (AF). However, the evolution of antiarrhythmic drug (AAD) use has stagnated. Many healthcare professionals (HCPs) have limited familiarity with these agents and remain unsure when to initiate and use AADs, partially driven by misunderstandings regarding the effectiveness and safety profiles of AADs. In this review, we focus on the unmet needs of AAD use, including the requirement for a patient-centered approach to AF management, how lifestyle and risk factor modifications can complement pharmacological intervention with AADs, and the benefits of shared decision-making between patients and HCPs. Additionally, the populations of people with AF for whom AADs may be most beneficial are discussed along with the role of AADs as an adjunctive component to other medical strategies for AF management. Lastly, we explore what future data are needed to better guide the use of AADs in managing AF.