[Fibrillation, an epidemic in the elderly?]

Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice. In its non valvular form, it appears as a disorder of the aged. Surprisingly, its incidence and prevalence have constantly been on the rise over the last decades to the extent that some authors nowadays call this phenomenon an "emerging epidemic". The reasons for that proliferation are not entirely elucidated. Obesity, which has simultaneously and similarly increased in frequency, might have played a significant role. AF is frequently pauci-symptomatic in the aged and can easily go unrecognized. Yet, it entails a higher mortality rate, carries a significant risk of thrombo-embolic events, in particular strokes, and may lead to heart failure. We shall briefly review the current epidemiologic aspects of AF and evoke the possible role of obesity. We shall then discuss the therapy of this disorder with a particular attention to the new oral anticoagulants.