Atrial fibrillation

Atrial fibrillation (AF) is an abnormal heart rhythm characterized by an irregular and often rapid heartbeat. Normally, the heart contracts and relaxes following a regular beat. In atrial fibrillation, the upper chambers of the heart (the atria) beat chaotically out of coordination with the lower chambers. AF results in an irregular, often fast heartbeat.

Atrial fibrillation may be:

Paroxysmal. In this type of AF, episodes come and go spontaneously and can last for a few minutes up to a couple of days.
Persistent. If episodes last longer than a week but less than a year, one speaks of persistent AF. This type of AF is typically treated by electrical cardioversion or antiarrhythmic drugs.
Permanent. If AF has become a chronic disease, the regular heart rhythm cannot be restored.

Even though untreated atrial fibrillation increases the risk of stroke and has been associated with a two-fold higher risk of heart-related death, many patients are unaware that it is a serious condition. While some people with atrial fibrillation have no symptoms, other patients may suffer from palpitations, fatigue, weakness, shortness of breath, inability to do exercise, and complications such as left ventricular dysfunction.

AF affects approximately 2 % of the European and North American population, which corresponds to double the prevalence of AF reported in the last decade. In Europe and the US, respectively, 8 % and 9 % of people aged 65 years or older have AF. This translates to 8 million people above the age of 65 years suffering from atrial fibrillation in the EU alone. In the coming decades, prevalence is estimated to rise by 89 %. The prevalence of AF increases with age and is higher in people who suffer from cardiovascular disease and other co-morbidities, including diabetes mellitus, obesity, or chronic kidney disease. The estimated lifetime risk of developing AF is about 25 % for both men and women older than 40 years of age. Hospitalizations due to AF account for one third of admissions for cardiac arrhythmias. In addition to the significant impact AF has on quality of life, the disease therefore also imposes a significant economic burden on the healthcare system.

By 2030, 14 to 17 million people are estimated to suffer from AF in Europe. In the US, the number of AF patients is expected to rise to 9 to 11 million. Considering the significant morbidity and mortality associated with AF, this increasing number of patients with AF will result in a major public health issue.