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 Ca(2+) 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.