Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in adults worldwide with a prevalence thought to be 2% to 4%. (1).
- AF prevalence is estimated to be approximately 3% in adults aged 20 years or older with greater prevalence in older persons and in patients with conditions such as hypertension, heart failure, coronary artery disease (CAD), valvular heart disease, obesity, diabetes mellitus, or chronic kidney disease (CKD)
- age-adjusted incidence and prevalence of AF are lower in women while the risk of death in women with AF is similar to or higher than that in men with AF (1).
In the UK, AF affects around 1.5% of the population.
- the “true” prevalence may be higher (2%) since patients with undiagnosed disease (silent AF) may never present to a clinician with symptoms of possible AF (2).
It is uncommon in children and healthy young individuals, with the prevalence generally increasing with age, from <0.5% in 40–50 years to 5% in those >65 years and 10% in those >75 (2,3)
It has been found to be greater in men than women (1.1% versus 0.8%),
Although studies on prevalence and incidence of AF in non white population are fewer, lower values have been reported for Asians and Afro-Americans (3).
A global study assessing cardiovascular disease from 1990 until 2019 found that (4):
Atrial fibrillation (AF) and atrial flutter (AFL)
- The estimated prevalence of AF and AFL was 59.7 million (95% UI: 45.7-75.3 million) in 2019.
- The prevalence for AF and AFL was unchanged between 1990 and 2019, when adjusted for age and population size (775.9 per 100,000 [95% UI: 592.4-990.8 per 100,000] in 1990 vs. 743.5 per 100,000 [95% UI: 571.2-938.3 per 100,000] in 2019).
- The estimated death rates were similar in 1990 (4.3 per 100,000 [95% UI: 3.7-5.1 per 100,000]) and 2019 (4.4 per 100,000 [95% UI: 3.7-5.0 per 100,000]).
- The total number of DALYs caused by AF and AFL increased from 3.79 million (95% UI: 2.96-4.83 million) in 1990 to 8.39 million (95% UI: 6.69-10.5 million) in 2019. The DALY rates during this period were similar (110.0 per 100,000 [95% UI: 87.7-139.2 per 100,000] in 1990 vs. 107.1 per 100,000 [95% UI: 86.2-133.7 per 100,000] in 2019).
- The DALY rates were highest in high-income North-America, Australasia, Central Asia, and Europe and lowest in the Asia Pacific region
Age as the only risk factor for AF:
- a Canadian cohort study (n=16,351) found stroke risk more than doubled as men & women with AF but no other CHA2DS2-VASc risk factors aged from 66 to 74 years (from 0.7% at 66 years to 1.7% at 74 years) (5)
Reference:
- Hindricks G, Potpara T, Dagres N, et al. 2020 ESC guidelines for the diagnosis and management of atrial fibrillation developed in collaboration with the European Association of Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2021 Feb 1;42(5):373-498.
- Bajpai A, Savelieva I, Camm AJ. Treatment of atrial fibrillation. Br Med Bull. 2008;88(1):75-94.
- European Heart Rhythm Association et al.Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J. 2010 (19):2369-429.
- Roth GA et al. Global Burden of Cardiovascular Diseases and Risk Factors, 1990-2019: Update From the GBD 2019 Study.J Am Coll Cardiol. 2020;76:2982-3021.
- Abdel-Qadir H, Singh SM, Pang A, et al. Evaluation of the Risk of Stroke Without Anticoagulation Therapy in Men and Women With Atrial Fibrillation Aged 66 to 74 Years Without Other CHA2DS2-VASc Factors. JAMA Cardiol. Published online May 19, 2021.