• atrial fibrillation

Atrial fibrillation (AF) is the most common arrhythmia worldwide and the estimated global age adjusted prevalence was 0.5% in 2010, representing nearly 33.5 million individuals.1 The prevalence is likely underestimated as a large proportion of asymptomatic individuals and those having transient symptoms remain undiagnosed. It is recognised as a global public health problem due to its significant burden of morbidity and mortality resulting from embolic stroke, congestive heart failure and acute coronary syndrome. AF may affect functional status and impairs the quality of life. The incremental cost related to AF in the USA is estimated at US$6–26 billion per year.2 Thus, AF already has tremendous implications on the economy and public health.

Numerous studies have reported AF as a growing epidemic with an expected doubling of its prevalence by 2030.3 However, most of the studies were conducted in the western world and epidemiological studies of AF in the Asian continent are scarce. Furthermore, the healthcare implications of the rapidly changing population dynamics in this region are poorly understood. As the prevalence is expected to rise, it is important to have an updated epidemiology of AF in order to allocate human and economic resources for appropriate healthcare planning. Two thirds of the AF-related healthcare expenses are from direct and indirect inpatient cost. Tremendous regional variation in hospitalisation for AF has been reported. Hence, the analysis of utilisation of hospitalisation is key to allocate resources accordingly.

In this context, Kim et al used the National Health Insurance Service (NHIS) database of Korea to describe the temporal trends of hospitalisation, costs, treatment …