Summary Atrial fibrillation (AF) is the most common arrhythmia, increasing in prevalence with age characterized by chaotic contraction of the atrium. An estimated 2.2 million people in the United States and 4.5 million in the European Union have AF.[1,2] AF is associated with heart failure, hemodynamic impairment, and symptoms affecting quality of life. Patients have an increased risk of thromboembolic events, including stroke, resulting in significant morbidity, mortality, and costs. [1-5]