Abstract

ZONI BERISSO, Massimo. Atrial fibrillation: a serious public health issue. Rev.Urug.Cardiol. [online]. 2015, vol.30, n.3, pp.347-356. ISSN 0797-0048.

In the last 20 years atrial fibrillation (AF) has become one of the most important public health issues. Its prevalence (2%) is double than that reported at the end of the last decade and it increases with aging. AF occurs more frequently in males than in females with a ratio of 1.2:1. The incidence of AF ranges between 0.21 and 0.9 per 1000 person/years. The most frequent form of AF is permanent AF that occurs in approximately 50% of patients while the paroxysmal and the persistent forms occur approximately in 25% of patients each. AF is frequently associated with cardiac diseases and comorbidities. The commonest concomitant diseases are: coronary artery disease, valvular heart disease and cardiomyopathies. The commonest comorbidities are: hypertension, diabetes, heart failure, chronic obstructive pulmonary disease, renal failure, stroke and cognitive disturbances. Paroxysmal AF occurs in younger patients and in contrast with the persistent and the permanent forms is associated with a reduced burden of both cardiac diseases and comorbidities. Generally, the history of AF is long lasting, characterized by the progression from the paroxysmal to the permanent form, burdened by frequent recurrences and disturbing symptoms. Patients with AF have a risk of stroke and death 5 fold and 2 fold higher than normal people respectively. In the real world, patients with AF are still undertreated with oral anticoagulants and in a discrete percentage of cases assigned to inappropriate antiarrhythmic strategy or treated with inadequate specific antiarrhythmic drugs. AF management is costly; expenditure per patient/per year is significantly different in different countries. Efforts to improve the implementations of guidelines recommendations are needed to improve furtherly the quality of care.

Keywords : ATRIAL FIBRILLATION; PUBLIC HEALTH; incidence; ATRIAL FIBRILLATION; epidemiology.

        · abstract in Spanish     · text in Spanish     · Spanish ( pdf )