It has been well documented that atrial fibrillation (AF) leads to serious consequences for many who suffer from it. This has presupposed that conversion to, and maintenance of, normal sinus rhythm (NSR) is beneficial. OBJECTIVE: The purpose of this study was to compare the long term benefits associated with NSR compared with AF. METHODS: A state-transition model was developed which compares an AF cohort to a converted population in NSR with otherwise identical characteristics. Consequences were grouped into 3 categories: symptoms (e.g., palpitation), moderate events/states (e.g., angina), major events/states (e.g., stroke). In addition, reversion to AF was allowed for the NSR cohort. Rates of consequences were identified through a review of the literature and clinical trial data. Cost estimates for all consequences and maintenance therapy (but not for conversion) were developed based on data from 5 all payer, state discharge databases using ICD-9 codes to identify disease and procedure level data. These sources were supplemented by fee schedules, other agency and survey data and the literature. All costs are reported in 1998 US dollars, adjusted for medical inflation and cost-to-charge ratios. RESULTS: Life expectancy increases 1,104 years (LYG) for the 1,000 person NSR cohort at a reduced cost of $3,323 per patient. These savings result from 31.9 fewer major adverse events (death, stroke, ICH). Additionally, NSR patients are expected to experience 14 - 33% fewer days AF-related with symptoms per year. CONCLUSION: This study suggests that there are substantial economic and health benefits to converting and maintaining AF patients in NSR. There remains, however, a need to study the long term effects in a converted NSR population as the only available data, to date, are for native NSR populations. “ECONOMIC & OUTCOMES ISSUES OF PSYCHOLOGICAL/NEUROLOGICAL DISORDERS”