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Racial Differences in Atrial Fibrillation Epidemiology, Management, and Outcomes

  • Arrhythmia (R Kabra, Section Editor)
  • Published:
Current Treatment Options in Cardiovascular Medicine Aims and scope Submit manuscript

Abstract

Purpose of the review

Atrial fibrillation (AF) is the most common sustained arrhythmia encountered in clinical practice and is associated with significant morbidity and healthcare cost. Most of the AF studies have predominantly included white population, with under-representation of minority population. In this review, we analyze the racial differences in epidemiology, disease awareness, risk factors, genetics, treatments, and outcomes of AF.

Recent findings

African Americans have a higher prevalence of established AF risk factors but lower incidence and prevalence of AF than non-Hispanic whites. There is also a significant racial and ethnic differences in the prevalence of AF-related symptoms and the detection and awareness of AF. Non-white patients are afforded decreased use of rhythm control treatment strategies and anticoagulation both with warfarin and NOACs for stroke prevention. They are less likely to receive catheter ablation (CA) of AF, compared with non-Hispanic whites. AF in the minority racial and ethnic groups carries increased morbidity and mortality compared with white groups, especially in the black individuals with AF, who have been shown to have a lower QoL compared with their white or Hispanic counterparts. Minorities experience stroke more frequently than the whites which is usually more severe and disabling.

Summary

There are significant racial differences in AF risk factors, manifestations, management, and outcomes. Recognition of these differences will aid in developing better preventive and treatment strategies for AF to decrease morbidity and mortality. In addition, this knowledge will enhance our understanding regarding the pathophysiology of AF including genetic predisposition.

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  1. Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA

    Amit Nanda MD

  2. Division of Cardiology, Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, 38163, USA

    Rajesh Kabra MD

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Amit Nanda declares no potential conflicts of interest. Rajesh Kabra has licensed technologies from Icahn School of Medicine at Mount Sinai to Rx. Health Digital Therapeutics Prescribing Platform. Dr. Kabra is the section editor of the Arrhythmia section of Current Treatment Options in Cardiovascular Medicine.

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Nanda, A., Kabra, R. Racial Differences in Atrial Fibrillation Epidemiology, Management, and Outcomes. Curr Treat Options Cardio Med 21, 85 (2019). https://doi.org/10.1007/s11936-019-0793-5

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