Assessing the landscape of any major public health challenge and the effectiveness of existing health care practices is a difficult proposition in any circumstance for health care planners and providers. To do so with relatively current health care data has not been a feasible reality. Too often health care planners have been relegated to use of venerable but dated clinical information. Equally often, clinical trial data collected for a purpose other than outcomes research have been extrapolated well beyond their original intent. The field of atrial fibrillation is no exception.