Atrial fibrillation (AF) is the most prevalent sustained cardiac arrhythmia in clinical practice associated with
significant morbidity and mortality. With the growing number of the affected individuals, the development of safe and effective
treatment options for AF has become a worldwide priority. Currently available antiarrhythmic medications for the
restoration and maintenance of sinus rhythm have limitations due to the modest efficacy and a potential for adverseeffects.
Although substantial progress has been made in AF-ablation techniques, broad application of these nonpharmacological
treatment modalities is limited and antiarrhythmic drug treatment is still the cornerstone and the first-line
therapy for the majority of AF patients. Improvements in the understanding of the principal pathophysiological mechanisms
of AF obtained in the last several years have provided promising treatment opportunities. New therapeutic options
are based on the more selective targeting of ion channels and intercellular connection proteins predominantly expressed in
the atria, the restoration of intracellular Ca2+ homeostasis and the prevention of AF-associated electrical and structural remodeling.
In this review, we provide a highlight of the most important pathophysiological mechanisms in AF with a relation
to the potential therapeutic interventions, and discuss novel findings regarding the current and future pharmacological
AF management and recent patents.
Keywords: Arrhythmia, antiarrhythmic drugs, atrial fibrillation, ion channels.
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