Atrial fibrillation (AF) is one of the most common types of supraventricular tachycardia arrhythmias characterized by chaotic electrical activity of the atria with a frequency of 350–700 per minute, which rules out the possibility of their coordinated contraction. Despite the fact that AF paroxysms are more common in men, women have much higher risk of strokes associated with atrial fibrillation, they have a higher degree of disability due to complications of arrhythmia and, accordingly, a lower quality of life. Gender differences should be taken into account in the treatment of AF in order to reduce risks and improve the quality of life. There are important factors such as a higher base heart rate, a longer QT interval than in men, lower serum potassium levels, and hormonal fluctuations during the phases of the menstrual cycle predispose to arrhythmias. Women receiving specific antiarrhythmic therapy for symptomatic AF are subjected to a higher proarrhythmogenic effect of drugs in the form of polymorphic ventricular tachycardia, and bradycardia requiring the implantation of a pacemaker. Hypokalemia may increase the tendency to proarrhythmogenic action of antiarrhythmic drugs. Potassium level should be monitored closely as hypokalemia is more common in women. Clinicians should take into account that hormonal fluctuations during the menstrual cycle can prolong the QT interval which, in turn, increases the risk of polymorphic ventricular tachycardia when using potassium channel blockers. Anticoagulant therapy should be carefully selected for women to eliminate the risk of bleeding. However, frequent refusal to take warfarin due to fear of bleeding leads to a large number of thromboemboluses. Self-monitoring can play a very positive role in finding this balance. In addition, new methods of protection against thromboemboluses associated with AF are being sought and clinically tested, for example, the installation of left atrial appendage occluder. This device can become a lifetime prevention of strokes in women who do not receive warfarin and have high risks of bleeding. Women with AF turn to ablation less often and later than men. Despite this, the result of ablation is approximately the same in both sexes. Thus, women's commitment to radiofrequency ablation should increase. Finally, women with AF have a significantly lower quality of life. Providing heart rate less than 80 beats/min, using a frequency control strategy, self-monitoring of patients significantly improves their quality of life.