Atrial fibrillation: is the prevalence rising?

This editorial refers to ‘Low prevalence of atrial fibrillation in asymptomatic adults in Geneva, Switzerland’ by M. Schmutz et al. , on page 475. Atrial fibrillation is a common arrhythmia in the general population but a rare disease before the age of 55 years. It is characterized by a steeply increasing prevalence with advancing age. The median age of persons with atrial fibrillation is 75 years. Unfortunately, it is not an innocent bystander of old age. Increased morbidity and mortality from thrombo-embolism, heart failure, and impaired cognitive function have been reported. Additionally, atrial fibrillation has been associated not only with rising costs for the community, but also with loss of quality of life at the individual level. Important risk factors for atrial fibrillation are hypertension, heart failure, diabetes mellitus, a history of myocardial infarction, valvular disease, obesity, smoking of cigarettes, and asymptomatic generalized atherosclerosis. The first figures on the prevalence and incidence of atrial fibrillation in the general population came from studies in the USA,1,2 followed by figures … *Corresponding author. Tel: +31 107043447; fax: +31 107044657, Email: j.heeringa{at}erasmusmc.nl