Atrial fibrillation: an emerging epidemic?(Editorial)

An aging general population, coupled with improved treatments for those individuals with coronary artery disease, hypertension, or heart failure, has led to a dramatic increase in the prevalence of atrial fibrillation

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Heart 2004;90:239-240. doi: 10.1136/hrt.2003.014720

Atrial fibrillation (AF) is the most common arrhythmic condition facing physicians, afflicting almost 1 in 20 people over the age of 60. (1) The prevalence of AF is on the rise, due, in part, to an aging general population and to increased longevity resulting from improved medical care among patients with coronary artery disease, hypertension and heart failure--all chronic cardiac conditions which predispose to AF. (2) (3) It is estimated that slightly less than 1% of the general population (well over two million in the USA) currently have AF, and the prevalence will increase 2.5-fold by the year 2050. (1) Prevalence figures for AF are underestimates because AF may be undiagnosed if sporadic and if not associated with significant symptoms.

AF is clinically important because it contributes to the incidence of heart failure, stroke, and both overall and cardiovascular mortality. The mechanism(s) by which AF contributes to increased mortality rate (2) (4-6) is currently uncertain. Moreover, no treatment of AF to date has resulted in a lower overall death rate. (7) Indeed, it is conceivable that conventional treatment with antiarrhythmic drugs may contribute to the higher death rate observed in AF populations. (7) (8) Equally troubling are the potential financial burdens…