Management of Atrial Fibrillation: From Palliation to Intervention

Next to premature beats atrial fibrillation is the most common arrhythmia in man and has even been designated the grandfather of all arrhythmias[1]. Atrial fibrillation occurs only sporadically in younger people. It is a condition more prevalent in the older age group. Prevalence in the general population is 0.4%. However, in patients over 70 years of age this may increase to 10% to 25%, which figure even increases to up to 40% in those with congestive heart failure[2,3]. The prognosis of patients with atrial fibrillation is strongly determined by the risk of stroke. Data from the Framingham study indicate a 4.8 fold increase risk of stroke, which increases with age[4]. The outcome of recent trials indicates that this risk may be reduced by oral anticoagulant therapy and aspirin treatment [5, 6, 7].