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“Atrial fibrillation is widely accepted as a condition of the elderly, however, around half of patients presenting with paroxysmal atrial fibrillation are less than 60 years old.” This conclusion was recently reached by a group of French, German, Dutch, Italian and Spanish electrophysiologists. It supports the findings in LAF Survey 9 (December 2005) which revealed that 60% of the over 600 survey participants were diagnosed at or before the age of 50 years. So, if aging is not the major cause of AF, what is?
In this issue an international group of EPs confirms that flecainide is safe and effective, and should be the first choice drug for afibbers with no underlying heart disease.
The issue of bleeding risk when on anticoagulants (warfarin) or antiplatelet agents (aspirin, clopidogrel) is finally being addressed with the development of a new scoring system,
HAS-BLED, which will allow physicians to better estimate the benefit/risk ratio of antithrombotic treatment. Dabigatran (Pradaxa) may replace warfarin for pre- and post-cardioversion
anticoagulation, and continuing warfarin therapy during catheter ablation procedures essentially eliminates procedure-related stroke risk.
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