Cardioversion and anticoagulation are essential in most patients. Stephen C. Remole, MD A trial fibrillation is the most common sustained arrhythmia in humans. Advanced age and the presence of structural heart disease correlate with increased incidence.
Hypertension is often a concomitant condition.
Despite the prevalence of atrial fibrillation, controversies regarding proper management abound. Consequently, many laboratories around the world are currently focusing their resources on establishing scientifically based guidelines for treating this arrhythmia. Finally, in some patients, the likelihood that direct-current cardioversion will be successful is so low that there seems little to be gained by attempting it. Factors that bode poorly for its success include the presence of mitral valve disease, age over 75 years, and an extended period of atrial fibrillation. Despite these drawbacks, there are some good reasons to proceed with direct-current cardioversion in many patients with paroxysmal atrial fibrillation.