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risk of embolic stroke inc 5x with AF
M>F 1.5x

Paroxysmal AF - terminates within 7 days usually within 48hrs
Persistent AF - not self terminating, lasting >7days
Permanent AF - long standing (>1yr), that doesn't stay reverted unless eg ablation done

1% population (18% of over 85's)
M>F

Lone, HT, cardiac disease, respiratory disease, genetics, hyperthyroid, alcohol / caffeine, infection, sarcoid

aSx, palpitations, heart failure, syncope, 

''Ix'' - ECG (?24hr tape), echo/CXR/TFT FBC U/E LFT

''Mx''
control rate or rhythm
thromboprophylaxis - stroke risk
treat underlying cause - infection, thyroid
treat heart failure
stop smoking, less alcohol and caffeine

''Rate control''
 >65yrs, persistent, cardiac disease (so unlikely to revert)
aim for ventricular rate of <80 and 90-110 with exertion
rate limiting ''CCB'' (Verapamil or Diltiazem NOT Amlodipine) or ''BB'' (doesn't have to be cardio-selective but ?better) (not with verapamil)
''Digoxin'' - OK if sedentary but not inc with exercize - useful as 2nd drug or in heart failure

''Rhythm control'' (2ndary care)
better if paroxysmal, cause treated, younger, Sx, no structural disease, heart failure, 2ndary to corrected precipitant (eg alcohol)
cardioversion - 80% success, needs full anticoagulation - 3/52 before and 4/52 after unless AF<48hrs
''flecainide or sotalol''- if no structural abN
''amiodarone'' - OK if structural abN, helps maintain SR, lots SE
electrical - 
as emergency if haemodynamically unstable - electrical or IV amiodarone

Thromboprophylaxis
aspirin alone is not enough
warfarin or rivaroxaban (or dabigatran)
reduces risk of stroke by 70%