Atrial fibrillation affects approximately 3 million people in the United States and creates a huge burden on the health care system, both in terms of morbidity, mortality, and cost.¹ The prevalence of atrial fibrillation rises sharply with increases in age. It is estimated that 8% of people above 70 years of age have atrial fibrillation.^2-4 Atrial fibrillation has long been recognized as a powerful risk factor for stroke,⁵ heart failure,⁶ and mortality.⁷Advancing age amplifies the risk of all of these sequelae of atrial fibrillation.⁸

As a subset, post-operative atrial fibrillation (POAF) after cardiac surgery is a common entity that is associated with significant morbidity and increased long-term mortality.^9-11 POAF in the setting of coronary artery bypass graft surgery CABG has been associated with increases in health care costs estimated around $10000 per patient affected.¹² Procedural risk factors of post-operative AF include valve surgery, pulmonary vein venting, bicaval venous cannulation, and longer cross-clamp times.¹⁰ Patient risk factors for POAF include male gender, renal dysfunction, congestive heart failure, and left atrial enlargement,¹⁰ the most powerful predictor, however, remains age.^13,14 As the number of elderly patients undergoing surgery increases, there has been more interest in investigating the predictors and sequelae of post-operative atrial fibrillation. The search for cost-effective, efficacious, and safe preventive therapies in high-risk patients is increasingly important.