Abstract
Atrial fibrillation (AF) is associated with embolic accidents and heart failure as well as increased mortality.1 Associated heart disease is known to be an important factor determining mortality.1 On the other hand, the significance of the arrhythmia in patients with lone AF has been more difficult to prove perhaps because of the difficulty of measuring the time spent in AF, the burden of AF, and thus establishing a dose–effect relationship. Somewhat paradoxically, a recent consensus statement2 does not distinguish between the prognostic implications of paroxysmal vs long-standing chronic AF while at the same time recommending anticoagulation before cardioversion of long-lasting AF but not for AF of recent onset.

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