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Atrial fibrillation: global burdens and global opportunities
  1. Jelena Kornej1,2,
  2. Emelia J Benjamin3,
  3. Jared W Magnani4
  1. 1 Cardiovascular Medicine and Preventive Medicine, Boston University Medical Center, Boston, Massachusetts, USA
  2. 2 IMISE, Leipzig University, Leipzig, Germany
  3. 3 Epidemiology Department, Boston University Medical Center, Boston, Massachusetts, USA
  4. 4 Department of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
  1. Correspondence to Dr Jelena Kornej, Cardiovascular Medicine and Preventive Medicine, Boston University Medical Center, Boston, MA 02118, USA; jkornej{at}

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There are large knowledge gaps regarding the global epidemiology of atrial fibrillation (AF), in part due to the paucity of informative community-based or population-based studies representative of the world’s population. The 2019 global burden of AF is estimated at 59.7 million (95% confidence interval: 45.7 to 75.3 million), double the number of estimated cases in 1990.1 Low-income nations—and one could argue entire continents such as South America, Africa and parts of Asia—face the multiple public health challenges of limited economic resources, progressively ageing populations, and increasing prevalence of common AF risk factors such as hypertension and obesity.

Unfortunately, most of the literature describing the epidemiology of AF is from high-income countries, such as the USA, Western European countries and Australia. This literature has consistently described the prevalence of the condition, its significant medical and societal costs, and its priority as the most commonly encountered cardiovascular arrhythmia. In contrast, data from much of Asia, Africa and South America are less available. A Web of Science search for AF articles published over the past 5 years conducted on 14th December 2020 (figure 1) reinforces marked imbalances in the country of origin of the AF literature with regards to the number of publications versus the population. The bottom line is a literature that is hardly representative; a small percentage of the world’s population has produced a large quantity of the literature on a condition that is increasingly common and prevalent across the globe. To develop a more comprehensive picture of AF will require investigations that represent the socioeconomic and geographical complexities across multiple nations and continents.

Figure 1

Atrial fibrillation (AF) research distribution according to the country within the last 5 years. The figure presents a Web of Science search for AF scientific papers published over the past 5 years conducted on 14th December 2020. In total, 43 509 …

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  • Correction notice The ORCID iD for author Emelia J Benjamin was omitted when first published Online First. This has now been added.

  • Contributors JK: conceptualisation, writing original draft, final revision and editing, funding acquisition, figures. EJB: conceptualisation, revision and editing. JWM: conceptualisation, revision and editing.

  • Funding JK received funding from the Marie Sklodowska-Curie Actions under the European Union’s Horizon 2020 research and innovation programme (Agreement No 838259). EJB was supported by NIH 2R01 HL092577; 2U54HL120163; 1R01AG066010; 1R01AG066914; American Heart Association, 18SFRN34110082. JWM is supported by NIH R01HL143010 and R33HL144669.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting, or dissemination plans of this research.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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