The patient is a 55-year-old male presenting in the office today. He is here for a 2-year follow-up for atrial arrhythmia. He denies a history of surgical intervention for this condition. He continues on an anticoagulant daily. He denies any palpitations, chest pain, shortness of breath, syncope or near syncope, and lower extremity edema. He uses a CPAP at night and denies any paroxysmal nocturnal dyspnea.