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Upstream Management of Atrial Fibrillation

JANE C CALDWELL AND CLIFFORD J GARRATT

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia worldwide, and currently afflicts approximately 2.3 million people in the US alone [1]. The prevalence of AF increases with age, from <0.1% of individuals aged <55 years to 9% of those aged >80 years; therefore, the burden of this arrhythmia is set to rise with our increasingly aging population. This, together with the associated increased risk of stroke, heart failure (HF), cognitive dysfunction, and death [1], means that AF presents a major current and future health concern. Conventional treatment of AF, involving either rate or rhythm control, acts only to manage the arrhythmia once it is established but does not prevent it from developing in the first place.

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