Recent progress in the epidemiology of atrial fibrillation

Atrial fibrillation is a common arrhythmia with serious health consequences. This review explores contributions to the characterization and control of atrial fibrillation made by recent epidemiologic efforts.

Topics included in this review include the classification and clinical progression of atrial fibrillation, the burden atrial fibrillation places on the individual and on the health care delivery system, temporal trends in the occurrence and effect of atrial fibrillation, and novel predictors and risk factors. In light of the clinically relevant classification system used in the 2001 American College of Cardiology/American Heart Association/European Society of Cardiology Practice Guidelines for atrial fibrillation, recent estimates of pattern-specific recurrence and progression rates are described, along with insights into the incidence and prognosis of primary and secondary atrial fibrillation. Important new studies from North America and Europe quantifying the alarming health care burden and economic effect of atrial fibrillation are summarized. A discussion of several novel risk factors recently found to be associated with the development of atrial fibrillation is also included.

Better characterization of the predictors, natural history, and clinical course of atrial fibrillation should ultimately support improvements in prevention, clinical decision making, and patient communication. A fuller comprehension of the current and future impact of atrial fibrillation can assist in planning health care delivery from the local facility to the international arena. Finally, there is a growing recognition that unraveling the complex interplay between atrial fibrillation and other associated diseases and their common risk factors may hold promise of deep insights into the fundamental nature of cardiovascular diseases.