High mean levels of D-dimers (DD), markers of fibrin product and degradation, have been reported in patients with atrial fibrillation. In order to determine the predictive value of DD, 125 consecutive patients (mean age, 78 years) with chronic atrial fibrillation without acute disease were prospectively included. DD were quantified by Liatest at inclusion. Patients were followed for a mean duration of 2 years. DD and age at inclusion were significantly higher in patients who would die (n = 54) than in those who would not (n = 65). After multiple analysis of variance, age was not significantly related to prognosis (P = 0.36); low DD (P = 0.03) and oral anticoagulant therapy (P = 0.0192) were independently related to survival. In conclusion, a single determination of DD can strongly predict survival over the following 2 years. It may contribute to the risk stratification and perhaps to the choice of the antithrombotic therapy in high-risk patients with elevated DD.