Atrial fibrillation: public health implications.
BACKGROUND
Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia in the United States, affecting 2.3 million Americans. AF is associated with significant morbidity, mortality, and poor quality of life. AF and its treatments result in high healthcare resource use and costs.


OBJECTIVE
To develop a framework for public health action for the prevention, detection, and control of AF.


METHODS
A literature search was conducted via MEDLINE and CINAHL for the 1990-2004 period. Key words included atrial fibrillation, epidemiology, prevention, detection, treatment, and public health.


RESULTS
Published data predict a substantial increase in the prevalence of AF due to improved survival of people with coronary heart disease; increasing prevalence of hypertension, heart failure, and diabetes; and the aging of the American population. Low public awareness of AF and quality-of-care issues related to detection, control, and management are evident.


CONCLUSIONS
Awareness, early detection and treatment, improved patient self-management, and attention by public health programs are essential to reduce the burden of AF. Partnerships among professional nursing and medical organizations, the Centers for Disease Control and Prevention, and patient advocacy groups represent another important approach to improving public health outcomes for AF. Hospitalizations for AF and controversies over optimal treatment strategies (e.g., rate vs rhythm control) underscore the need for both public health and applied research.
Valderrama
Amy L
AL
Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA. avalder@emory.edu
Dunbar
Sandra B
SB
Mensah
George A
GA
D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000517:prevention & control; D006760:Hospitalization; D006801:Humans; D008875:Middle Aged; D011634:Public Health; D011788:Quality of Life; D014481:United States