[Natural history and outcomes of atrial fibrillation].

Atrial fibrillation occurs most of the time without any symptom. The first symptomatic episode may follow many silent episodes. The natural history of atrial fibrillation is relatively chaotic from paroxysmal to persistent and permanent atrial fibrillation. The consequence is that antithrombotic treatment depends on global thromboembolic risk and not on patient's perception of arrhythmia or sinus rhythm presentation. Unfortunately, the first appearance may be the most feared complication: stroke. Stroke due to atrial fibrillation are frequent, severe, with high mortality rate during hospitalization and during the following year. The severity of stroke during atrial fibrillation could explain a certain degree of cognitive decline. Heart failure is also a frequent atrial fibrillation complication due to sharing of common causes. Through those two complications, atrial fibrillation raises mortality rate. Less importantly, though leading to frequent hospitalizations, quality of life impairment is relatively frequent.