Antiarrhythmic Drug Initiation for Atrial Fibrillation in the USA: How and Where

Atrial fibrillation (AF) is common and occurs in approximately 8% of adults over 65 years of age in the United States. Prevention of AF, with maintenance of healthy weight, treatment of sleep apnea, and regular exercise are key strategies. As prevention is often inadequate, the role of antiarrhythmic drugs (AADs) is paramount. Adverse events are often uncovered in the first 24 h of initiation, and occur approximately 10%-15% of the time, but AADs can still be used safely [2]. Herein, we describe the various categories in a practical guide to initiation to make clinicians more comfortable with starting and maintaining antiarrhythmic therapy in both the inpatient and outpatient setting. The central illustration summarizes the article.