Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia with a prevalence of 1–2% in the general population . The prevalence of AF increases with age and, in the elderly population, cardiovascular (CV) risk factors and co-morbidities such as hypertension, diabetes, congestive heart failure, coronary artery disease, valvular heart disease (VHD), and stroke are common .
The global prevalence and cost of AF are expected to surge owing to factors such as economic growth, an ageing population, and increased prevalence of risk factors for AF in both Western countries and rapidly developing countries such as Brazil, China, India, and Indonesia .
By 2050, the number of people with AF is projected to be 15 million in the United States , and a similar trend is projected for the European population too . For India, the United Nations Populations Fund has projected a 326% increase in the number of people aged between 60 and 80 years by the year 2050 (from the year 2000). A 700% increase is projected in the number of people above the age of 80 years .
Though large-scale population-based studies on the prevalence of AF are not available in India, the recently published PANARM HF trial showed an AF incidence of 15% across a population of 2205 patients symptomatic for cardiac arrhythmias or HF, who were indicated for implantable device/radiofrequency ablationThe MANDATE AF Study is a prospective randomized study aiming to show that a reduced Atrial anti-tachycardia pacing sequence programming, is as effective as Minerva trial programming.

The purpose of this study is to show that a reduced ATP sequence programming is non-inferior to Minerva study ATP programming with respect to time to persistent AF among Indian patients with a Cardiac Implantable Electronic Device (CIED).