A Rising Tide

In his seminal lecture to the Massachusetts Medical Society in 1997, Dr. Eugene Braunwald pointed to atrial fibrillation (AF) as an emerging epidemic of cardiovascular disease.1 At that time, information on the burden—prevalence, incidence, and associated outcomes—of AF in the general population was limited to a few epidemiologic studies, most of them conducted in the United States and Western Europe. Since then, dozens of publications have contributed to provide a clearer picture of the real impact of AF. These publications confirmed Dr. Braunwald's prediction, demonstrating that AF is the most common sustained arrhythmia in clinical practice and a major public health concern. In the last couple of years, two systematic reviews of the literature on global epidemiology of AF have provided concrete evidence of our increasing knowledge in this area.2, 3 Both reviews highlighted the growing prevalence and incidence of this arrhythmia globally, but also called attention to the limited information on AF epidemiology in developing countries. One of the reviews, for example, only identified six publications reporting the incidence of AF outside North American and Western Europe.2