Atrial Fibrillation

Abstract

Death rates are doubled in patients with AF, independent of all other known predictors of mortality. Only antithrombotic therapy has been shown to reduce AF-related deaths.7-9 A fifth of strokes are attributed to AF with AF-related strokes being more severe. Undiagnosed ‘silent AF’ is a likely cause of some ‘cryptogenic’ strokes.7,10 Asymptomatic cerebral emboli are common in patients with AF with an increased incidence of cognitive impairment and dementia being seen.11,12 Paroxysmal AF carries the same stroke risk as permanent or persistent AF.13 AF patients have a worse quality of life, with reduced exercise tolerance, even if believed to be asymptomatic.14 The quality of life is worse in AF patients compared with those having a history of myocardial infarction.15 It is thought in some patients AF results in impairment of left ventricular systolic function, with improvement of function after maintenance of sinus rhythm.16 mEchanisms