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Updated: Aug 26, 2025

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

Published on: February 26, 2013

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Racial, ethnic, and sex disparities in atrial fibrillation management: rate and rhythm control

Sofia E Gomez1, Muhammad Fazal1, Julio C Nunes2,3,4

  • 1Department of Medicine, Stanford University School of Medicine, 300 Pasteur Drive, H2146, Stanford, CA, 94305, USA.

Journal of Interventional Cardiac Electrophysiology : an International Journal of Arrhythmias and Pacing
|October 12, 2022
PubMed

Insights

Disparities exist in atrial fibrillation (AF) management and outcomes among women and racial/ethnic minorities. These groups face worse symptoms and less treatment despite lower AF prevalence, highlighting inequities in care and research representation.

Area of Science:

  • Cardiology
  • Health Disparities
  • Clinical Research

Background:

  • Atrial fibrillation (AF) impacts millions, requiring pharmacologic and interventional management for rate/rhythm control and stroke prevention.
  • Existing AF management strategies may yield different responses across diverse populations.
  • This review focuses on disparities in AF rate/rhythm control and outcomes for women and underrepresented racial/ethnic groups.

Purpose of the Study:

  • To explore sex and racial/ethnic disparities in AF rate and rhythm management.
  • To analyze the impact of these disparities on patient outcomes.
  • To review AF epidemiology and clinical trial diversity.

Main Methods:

  • Narrative review of existing literature.
  • Exploration of sex and racial/ethnic disparities in AF management.
  • Summary of AF epidemiology and landmark clinical trials.

Main Results:

  • Black and Hispanic adults have lower AF risk but more severe symptoms and lower quality of life than NHW patients.
  • NHW patients receive more frequent antiarrhythmic drugs, cardioversions, and invasive therapies.
  • Women experience more severe symptoms, heart failure, stroke, and death post-AF diagnosis; underrepresentation in trials may affect prevalence data.

Conclusions:

  • Social determinants like race, ethnicity, and gender influence AF prevalence, progression, and management.
  • Biological differences and treatment/research disparities contribute to observed impacts.
  • Addressing these disparities is crucial for equitable AF care.
Abstract

Keywords:
Atrial fibrillationDisparitiesRhythm control

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