What is the first-line treatment for stable atrial fibrillation?

The first-line treatment for stable atrial fibrillation typically focuses on heart rate control, making the use of beta-blockers or calcium channel blockers the most appropriate initial strategy. These medications work to slow down the heart rate by decreasing conduction through the AV node, which is crucial in managing the symptoms associated with atrial fibrillation, such as palpitations and shortness of breath.

In stable patients, the goal is to achieve a balance between maintaining a reasonable heart rate and ensuring the patient remains asymptomatic. Beta-blockers, such as metoprolol or atenolol, and calcium channel blockers, like diltiazem or verapamil, are commonly used due to their effectiveness and the ability to provide rapid control of the heart rate.

Anticoagulation therapy is important in the management of atrial fibrillation to reduce the risk of thromboembolic events, particularly stroke, but it is not a first-line treatment specifically aimed at controlling the immediate symptoms or heart rate. Cardioversion is considered when a patient is hemodynamically unstable or when there is a desire to restore sinus rhythm, but it is not the first approach for stable atrial fibrillation. Similarly, digoxin may be employed in certain cases, especially in