Atrial fibrillation

Cause

Atrial fibrillation (AF) is one of the most common clinically significant cardiac arrhythmia's; it has been predicted that 5–16 million adults in the United States and >1 million adults in Japan will be affected by AF by 2050. Available data indicate that the prevalence of AF may be lower in Asian countries than in Western countries. In individuals more than 80 years of age, the estimated prevalence is 2%–3% in Japan compared with 7%–14% in Western countries. The prevalence in the same age group has been reported as 5.8% and 4.0% in Singapore and Korea, respectively; the prevalence has been estimated to be 5.9% in individuals 80–84 years old in China. There are also potential differences between cultures in treatment practices and illness reporting, and in genetics. Despite these differences, AF-related epidemiological factors in Western and Asian populations could be similar.

AF is associated with an increased risk of embolic stroke, heart failure, and cardiovascular morbidity, and symptoms include palpitations, dizziness, breathlessness, and chest pain. The management of AF is focused on preventing complications associated with arrhythmia and reducing symptoms. Treatment includes conversion to sinus rhythm (SR); rapid cardioversion is preferable because delays of more than 12 hours for patients with short-duration (<48 hours) AF may increase the risk of cerebral ischemic attacks in the 30 days after conversion.