Cardiac arrhythmias are a major problem in elderly persons, because of the high 
prevalence of underlying heart disease and hypertension, arrhythmias are 
associated with significant morbidity and mortality in this age group. Atrial 
fibrillation (AF) is the most common sustained arrhythmia encountered in 
clinical practice. Its incidence increases with age and the presence of 
structural heart disease. It is a major cause of stroke, especially in the 
elderly. Although the established principles of evaluation and management of 
cardiac arrhythmias apply to all age groups, management in the elderly patient 
is especially challenging because of increased risk of interventional and 
pharmacologic therapies, altered pharmacokinetics of drugs, and sometimes 
unclear long-term benefits in the older patient.