AF is common in Europe, although the number of patients affected is probably underestimated.
AF incidence in Europe is between 21 and 41 per 100,000 of the population a year.2 AF prevalence in Europe varies from 1.9–2.9%.2,4,12 However, insertable cardiac monitors can detect previously undocumented AF, suggesting that these figures are probably underestimates.13
AF seems to be becoming more prevalent, partly because the condition becomes more common with advancing age (Figures 1, 2 and 3), partly because of an increased prevalence of AF risk factors, and partly because of improved survival follow acute coronary syndromes, such as myocardial infarction.2,12
The risk of developing AF doubles for each decade of life, for example.6 The Rotterdam study (figures 2 and 3) followed 6808 people aged 55 years and older for a mean of 6.9 years. Overall AF prevalence was 6.0% in men and 5.1% in women. The overall incidence was 11.5 and 8.9 per 100 patient years respectively. The lifetime risk of developing AF after the age of 55 years was 23.8% in men and 22.2% in women.14 In Europe, AF is more common in men than women: the male: female ratio is 1.2:1. Most AF patients are, however, female reflecting their longer average life expectancy.2
Around 5–8% of patients undergoing percutaneous coronary intervention (PCI, formerly known as angioplasty with stent) have AF and one in three patients with AF also has coronary artery disease.15–17 Patients with AF and acute coronary syndrome (ACS) and/or PCI are therefore considered a special population.18
AF incidence is lower in patients from certain ethnic backgrounds – for example, African Americans (3.8%), Hispanics (3.6%) and people of Asian descent (3.9%) compared with Caucasians (8.0%) – despite a higher prevalence of risk factors in some of these groups (Pistoia et al, 2016; Rogers et al, 2018). Patients of Caucasian descent may have a genetic predisposition to developing AF.6
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