Atrial Fibrillation Revisited

Atrial fibrillation is the grandfather of cardiac arrhythmias. Known in the 19th century as "arrhythmia perpetua," it was clearly defined clinically by MacKenzie and electrocardiographically by Lewis at the beginning of this century. Except for the development of direct-current shock therapy some two decades ago, the management of atrial fibrillation has changed little from that well described by Mackenzie in 1925.1 In the present era of sophisticated approaches to arrhythmias, atrial fibrillation has attracted little interest among electrophysiologists; its management still depends largely on the use of two of the oldest cardiac drugs: digitalis and quinidine.Yet atrial fibrillation remains . . .