• heart disease

Atrial fibrillation (AF) has emerged as one of the few cardiovascular diseases in which both the number of cases and the age-adjusted prevalence has increased over the last decades in developed countries, leading to a substantial economic burden. Most data on AF prevalence and outcomes comes from western countries. However, Kim and colleagues1 present an analysis of recent trends in the hospital-care burden of AF in an Asian country – South Korea. Using the National Health Insurance Service (NHIS) database, this nationwide cohort included 9 31 138 patients hospitalised for AF from 2006 and 2015. There was an overall trend towards an increase in AF hospitalisation from 767 to 3986 per 1 million Koreans (relative increase, 420%) over this time period. This increase in AF hospitalisation was observed in all age, sex and economic status sub-groups. The frequency of comorbidities and mean CHA2DS2-VASc and HAS-BLED scores also increased continuously during this period, as well as hospitalizations due to complications of both the AF and of its treatment, specifically major bleeding (figure 1). Mortality associated with AF hospitalizations decreased from 7.5% in 2006 to 4.3% in 2015 (relative decrease 42%), although hospital costs per year increased exponentially by 468% during this 10 year period. Considering that the length of hospital stay is relatively long in Korea, the …