Device therapy for atrial fibrillation

Abstract

Atrial fibrillation (AF) is by far the most common significant cardiac arrhythmia, affecting an estimated 4 million people worldwide. Its incidence may be increasing, and its prevalence increases as the population ages. Its hemodynamic consequences include decreased cardiac output, increased sympathetic nervous system activation, increased risk of thromboembolic complications, and abnormal rate response to exercise. The treatment of AF with antiarrhythmic drug therapy has been disappointing due to a low rate of e?cacy and potentially life-threatening side effects (1,2). The health care costs associated with management of this arrhythmia are staggering. AF accounts for over one-third of all hospital days and patient discharges where arrhythmia is coded as the principal diagnosis. The estimated cost of management of patients with AF in the United States alone is over $1 billion.