Atrial fibrillation is the most common cardiac arrhythmia. It is an independent risk factor for cardiovascular complications and stroke. The treatment options for atrial fibrillation have changed significantly in recent years by new drugs and ablative procedures. It is based on the principal strategies of anticoagulation, rhythm and rate control. Goal is to reduce symptoms and subsequent events. Although the costs of about 700 to pound 800 per patient per year are rather high, new treatment options might be associated with a reduction in event rates and an increase in quality adjusted life years (QALYs). The aim of this review is to give a practical overview of the epidemiology, diagnosis, treatment and costs to pharmacists who have a key role in the implementation of pharmacotherapy of atrial fibrillation.