In a Clinical Crossroads article published in October 2003,1 Daniel E. Singer, MD, discussed the epidemiology of, risk factors for, and treatment considerations for atrial fibrillation (AF). Mrs B, a 60-year-old woman with AF, was concerned about choosing the safest and most effective treatment option for her recently diagnosed AF. Between December 2000 and September 2002, Mrs B experienced palpitations, shortness of breath, and fatigue that increased in frequency and severity and were thought to be related to underlying AF. In September 2002, Mrs B began anticoagulation therapy. Comforted that she was safeguarding herself from stroke, Mrs B wondered about the long-term adverse effects of warfarin and was willing to consider other options. She discussed the possibility of elective cardioversion with her physician but was ambivalent about the adverse effects of subsequent flecainide therapy.
Mattson-DiCecca AA, Reynolds E. Update: A 60-Year-Old Woman With Atrial Fibrillation. JAMA. 2009;301(17):1808. doi:10.1001/jama.2009.507