Recent advances in the management of atrial fibrillation

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia in clinical practice, with over 3 million cases in the USA and 4.5 million in Europe. Its incidence is rising rapidly, and the number of individuals with AF is expected to triple or even quadruple between now and 2050. Most patients with AF are over 65 years of age and present many co-morbidities, in particular, hypertension (37%), heart failure (23%), coronary artery disease (18%), and diabetes (15%). The majority of patients with AF are elderly and 83% are aged over 65 years. This subset of patients is likely to continue to increase in number. AF is a major source of morbidity and mortality, being associated with reduced left ventricular function, exercise tolerance and quality of life, as well as a two-fold increase in cardiac mortality. In particular, the risk of stroke is increased five-fold in the presence of AF. Furthermore, patients with AF may experience symptoms adversely affecting their daily life. For all these reasons, restoration and maintenance of sinus rhythm in patients with AF is clearly an important therapeutic goal. The articles comprising this Supplement, in which newer aspects of AF management are discussed in depth by leaders in the field, reflect the debates on these controversial topics at the second CREATE Annual Advisory Meeting held in Berlin on 5 October 2007. Dr Stefan Hohnloser and colleagues, in their article ‘Prevention of Stroke in Patients with AF: Current Strategies and Future Directions’, address the issue of stroke triggered by the thrombo-embolic complications of AF. Owing …