Atrial fibrillation

In spite of tremendous advances in cardiovascular medicine over the last century, atrial fibrillation (AF) remains a significant cause of symptoms, hospitalization, morbidity and mortality. With an increasing and ageing population, the number of patients being treated with AF continues to rise with enormous demands on healthcare resources. Unfortunately, antiarrhythmic therapy remains only moderately effective at preventing AF, it needs to be patient-tailored and it can be associated with significant side effects. Additionally, oral anti-thrombotic therapy has barely altered in the last fifty years. Non-pharmacological therapies continue to be investigated, yet studies of the effectiveness of pacemaker therapies in AF and the atrial defibrillator have been mostly disappointing. Left atrial ablation is now being offered in large cardiac centres with promising results. With new anti-arrhythmics and antithrombotic medications on the horizon, perhaps we can at last offer hope for patients with this stubborn condition.