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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Atrial fibrillation prevalence revisited
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.
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.
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