The increasing burden of Chronic Kidney Disease (CKD) is highly relevant to cardiologists, as cardiovascular mortality is 10-30 times higher amongst people with ESRD, comparing with general population. One of the commonest associations is the increased frequency of atrial fibrillation (AF) amongst those experiencing CKD.

Overall, we know that AF is the most common cardiac arrhythmia. AF leads to a substantial risk of mortality and morbidity, from stroke and thromboembolism, heart failure, reduced cognitive function and impaired quality of life.  However, most clinical trials in AF (for example, for stroke prevention in AF with anticoagulation therapy) have largely excluded patients with significant renal impairment.