The mortality and morbidity from atrial fibrillation (AF) is due to the increased risk of stroke. Patients with AF have, on average, a five-fold increase in their risk of stroke compared to patients in sinus rhythm (the normal heart rhythm) and AF-related strokes are associated with increased mortality or higher levels of ongoing disability. Anticoagulation of the appropriate patients is a highly effective intervention. It will reduce an individual’s risk from an AF-related stroke by around two-thirds.

Atrial fibrillation is the commonest cardiac arrhythmia. It is estimated that the prevalence in the UK is in the region of 2.5 per cent – although there is a prevalence gap with around 30 per cent of cases undetected. Prevalence increases significantly with age with only 1-2 per cent of patients being aged 40-50 years. This rises to more than 10 per cent in those over the age of 80 years.

Patients may be symptomatic with typical symptoms being awareness of an irregular heartbeat, palpitations, dizziness or syncope (fainting or blackouts), shortness of breath and chest tightness. However, many patients are asymptomatic and unaware that they have this cardiac arrhythmia.

Prevalence