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Original research
Trends of global burden of atrial fibrillation/flutter from Global Burden of Disease Study 2017
  1. Lina Wang1,2,
  2. Feng Ze3,
  3. Jun Li4,
  4. Lan Mi5,
  5. Bing Han6,
  6. Huan Niu7,
  7. Na Zhao1
  1. 1Department of Cardiovascular Medicine, Shaanxi Provincial People’s Hospital, Xi'an, China
  2. 2Department of Neurology, Xi’an Ninth Hospital Affiliated to Medical College of Xi’an Jiaotong University, Xi'an, China
  3. 3Department of Cardiac Electrophysiology, Peking University People’s Hospital, Beijing, China
  4. 4Department of Cardiology, Tangdu Hospital, Airforce Military Medical University, Xi'an, China
  5. 5Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, Beijing, China
  6. 6Department of Cardiology, The First Hospital of Lanzhou University, Lanzhou, China
  7. 7Department of Cardiovascular Medicine, Shenzhen University General Hospital, Shenzhen, China
  1. Correspondence to Dr Na Zhao, Shaanxi Provincial People’s Hospital, Xi'an, China; 173307845{at}


Objective This study aimed to estimate the global burden of atrial fibrillation/atrial flutter (AF/AFL).

Methods We retrieved data from the Global Health Data Exchange query tool and estimated the age-standardised rates (ASRs) of prevalence, incidence and disability-adjusted life-years (DALYs) of AF/AFL, as well as the population attributable fraction (PAF) of risk factors contributing to DALYs. ASRs and sociodemographic index (SDI) were assessed using Pearson’s correlation coefficients.

Results In 2017, there were 37.6 million (95% uncertainty interval (UI) 32.5 to 42.6 million) individuals with AF/AFL globally. The prevalence rates increased with increased SDI values in most regions for all years. Men had a higher prevalence than women across all regions except for China. From 1990 to 2017, global prevalence rate decreased by 5.08% (95% UI −6.24% to −3.82%), with the largest decrease noted in the region with high SDI values. The global DALYs rate declined by 2.53% (95% UI −4.16 to −0.29). PAF of elevated systolic blood pressure for attributable DALYs accounted for the highest percentage, followed by high body mass index, alcohol use, high-sodium diet, smoking and lead exposure.

Conclusions Although the ASRs of prevalence, incidence and DALYs decreased from 1990 to 2017, the absolute number of patients with AF/AFL, annual number of new AF/AFL cases and DALYs lost due to AF/AFL increased. This indicates that the burden of AF/AFL is likely to remain high. Systematic surveillance is needed to better identify and manage AF/AFL so as to prevent its various risk factors and complications.

  • atrial fibrillation
  • atrial flutter
  • epidemiology

Statistics from


  • Contributors LW, FZ and JL analysed the data, drafted and revised the paper. LM, BH and HN prepared and analysed the data. NZ conceived and designed the study, interpreted the results, drafted and revised the paper. All authors provided critical comments on the manuscript. All authors read and approved the final manuscript.

  • Funding This work was supported by the Project of Shaanxi Provincial Nature Science Fund Distinguished Young Scholars (2018JQ8066) and the Research Program from Xi’an Jiaotong University (1191329109).

  • Competing interests None declared.

  • Patient consent for publication Not required.

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

  • Data availability statement Data are available in a public, open access repository. We retrieved data from the Global Health Data Exchange query tool (, an online tool of the Global Burden of Diseases, Injuries, and Risk Factors Study 2017. The database is hosted by the Institute for Health Metrics and Evaluation at the Washington University.

  • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.

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