Cardiac disease of various different types is one of the most common and important issues encountered amongst the residents of residential aged care facilities. Clinical problems affecting the heart can arise from various factors – in some cases because of sustained hypertension, in others related to elevated serum lipid concentrations (high cholesterol). Ischaemic Heart Disease (IHD) happens when the blood supply to the heart muscle is compromised, and Congestive Heart failure is seen when the heart muscle begins to have difficulty in being able to circulate blood around the body. All of these situations will be explored in detail in the Ward Medication Management publications over coming months, but in this edition we will look in more details at Atrial Fibrillation (AF), by far the most common type of cardiac arrhythmia observed in the aged and extended care setting. The prevalence of AF is lower for younger people (< 1% for people aged less than 60 years) but increases steadily with age, affecting up to 15% of people aged > 80 years.