Atrial Fibrillation: A Perspective: Thinking Inside and Outside the Box
A trial fibrillation (AF) is a common clinical problem that is increasing in prevalence 1 and is inextricably linked to another burgeoning cardiovascular problem, namely, congestive heart failure. 2 There is increasing evidence that AF, at least in some population subsets, may be part of a spectrum of atherosclerotic vascular disease, hypertension, inflammation, diastolic dysfunction, and the metabolic syndromes. AF is part of a family of atrial tachyarrhythmias (Figure 1) . A panel of experts
... A panel of experts has recently characterized the definition and position of AF within this group of tachyarrhythmias. 3 Nonetheless, this family of tachyarrhythmias is closely interrelated, and the individual tachyarrhythmias often coexist in the same patient. Although the present discussion focuses on AF, many of the points made with regard to AF apply to these other tachyarrhythmias to varying degrees. Recently, international panels of experts have also created clinical practice guidelines 4 and perspectives on future research directions 5 for AF. These documents are a rich source of reference to the vast literature on AF. It is not the intention of the present article to review this literature, and, in particular, it is not intended that the reader will use the present article as a manual for managing AF. However, the perspective is intended to provide a framework for rational thinking about the management of AF.