Atrial fibrillation is the most common sustained arrhythmia in clinical practice. It affects more than 2 million people in the United States, and an estimated 150000 new cases will be diagnosed each year.1  Because 4% of the US population more than 65 years old is affected, the costs to the health care system, especially Medicare, will be astronomical. Atrial fibrillation is a contributing factor in the development of angina, heart failure, and stroke.2  Thromboembolic events are the most feared complication of this disease. Patients with atrial fibrillation are up to 7 times more likely than the general population to have a stroke.3  The Centers for Disease Control and Prevention estimates that atrial fibrillation is responsible for more than 1.7 million hospitalizations of current Medicare recipients.3 

In this article, I describe the pathogenesis of atrial fibrillation, potential sequelae of this arrhythmia, and the treatment options. The major...

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