Nissinen M, Lehto J, Biancari F, et al. - Researchers investigated how preoperative paroxysmal atrial fibrillation (AF) affects outcome in patients undergoing surgical aortic valve replacement (SAVR) with bioprosthesis. From the national registry Statistics Finland, they assessed survival data of a total of 666 patients undergoing isolated AVR with a bioprosthesis. Division of these patients into three groups according to the preoperative rhythm was done: sinus rhythm (n = 502), paroxysmal AF (n = 90), and permanent AF (n = 74). Outcomes suggest a higher risk of developing permanent AF, cardiovascular mortality and incidence of fatal strokes among patients undergoing SAVR with bioprosthesis and history of paroxysmal AF compared with those with preoperative sinus rhythm. They recommend considering life-long anticoagulation in patients with a history of preoperative paroxysmal AF.