ABC of Atrial Fibrillation: HISTORY, EPIDEMIOLOGY, AND IMPORTANCE OF ATRIAL FIBRILLATION

Atrial fibrillation is the commonest sustained disorder of cardiac rhythm. When it is present many prognostic and therapeutic implications exist as overall morbidity and mortality increase appreciably. Despite this, atrial fibrillation is sometimes regarded as a fairly trivial and unimportant disorder and is often neglected, probably because many patients have few symptoms. In fact, some patients with chronic atrial fibrillation may require long term treatment with potent antiarrhythmic and anticoagulant drugs, which may have important pharmacological interactions and adverse effects. In addition, treatment differs importantly for chronic and paroxysmal atrial fibrillation and for atrial fibrillation, atrial flutter, and the other supraventricular arrhythmias.

Atrial fibrillation is encountered in many clinical settings. It may, for example, be discovered incidentally in an asymptomatic patient, develop in a patient who merely has a chest infection, or be found in a patient with a ventricular rate of 200 beats/min who is too lightheaded to stand up. Patients admitted with atrial fibrillation may have many cardiorespiratory symptoms and clinical features, including syncope and stroke.