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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation

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Published on: February 26, 2013

Atrial fibrillation prevalence revisited.

L Friberg¹, L Bergfeldt

¹Department of Clinical Science, Karolinska Institute, Danderyd Hospital, Stockholm, Sweden; Department of Cardiology, Danderyd Hospital, Stockholm, Sweden.

Journal of Internal Medicine

|July 25, 2013

Summary

The prevalence of atrial fibrillation (AF) in Sweden is at least 2.9%, significantly higher than previously estimated. Many patients, especially high-risk individuals, women, and the elderly, are undertreated with anticoagulants for stroke prevention.

Keywords:

anticoagulation atrial fibrillation epidemiology

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Area of Science:

Cardiology
Epidemiology
Public Health

Background:

Current US guidelines underestimate atrial fibrillation (AF) prevalence, potentially by 3-5 times, as they focus on permanent AF.
Stroke risk is comparable between paroxysmal and persistent AF, necessitating broader prevalence estimates.
Understanding AF prevalence is crucial for effective stroke risk management.

Purpose of the Study:

To determine the actual prevalence of atrial fibrillation (AF) in Sweden across all types.
To assess the extent of stroke prophylaxis, specifically oral anticoagulant use, among diagnosed AF patients.
To identify patterns of undertreatment and overtreatment in AF management.

Main Methods:

Retrospective analysis of the Swedish National Patient Register (2005-2010).
Inclusion of patients with a clinical diagnosis of atrial fibrillation (AF).
Cross-referencing with the National Prescribed Drugs Register for anticoagulant dispensing data.

Main Results:

Identified 307,476 individuals with atrial fibrillation (AF).
Calculated a clinically diagnosed AF prevalence of 2.9% in the Swedish adult population (≥20 years).
Only 42% of AF patients received oral anticoagulants within six months of diagnosis; high-risk patients were least likely to be treated.

Conclusions:

Atrial fibrillation (AF) prevalence in Sweden is at least 2.9%, exceeding US estimates.
Significant undertreatment of anticoagulation therapy observed, particularly in women and the elderly.
Over 80% of AF patients had risk factors warranting anticoagulation, highlighting a critical gap in stroke prevention.