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Epidemiology and natural history of atrial fibrillation: clinical implications

Sumeet S. Chugh, MD, FACC^*, Joseph L. Blackshear, MD, FACC, Win-Kuang Shen, MD, FACC^*, Stephen C. Hammill, MD, FACC^* and Bernard J. Gersh, MB, DPhil, ChB, FACC^*

^* Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo Foundation, Rochester, Minnesota, USA
Division of Cardiovascular Diseases, Mayo Clinic Jacksonville, Jacksonville, Florida, USA

View larger version (15K): [in a new window]   Figure 1 Prevalence of atrial fibrillation in four natural history studies. CHS = Cardiovascular Health Study; W Australia = Western Australia. (From Feinberg et al. [4]; by permission of the American Medical Association).

View larger version (17K): [in a new window]   Figure 2 Secular trends in the prevalence (percentage) of atrial fibrillation in subjects 65 to 84 years old in the Framingham study. (Data from Wolf et al. [13]).

View larger version (22K): [in a new window]   Figure 3 Pathophysiologic mechanisms and associations between atrial fibrillation and stroke. EF = ejection fraction; LA = left atrium; LV = left ventricle. (From Gersh [3]; by permission of Futura Publishing Company. Original figure, courtesy of J. H. Chesebro, MD).

View larger version (25K): [in a new window]   Figure 4 Analysis of thromboembolic risk in three studies of patients with lone atrial fibrillation according to the number of risk factors for stroke and age. (From Gersh BJ, Antithrombotic therapy in nonrheumatic/nonvalvular atrial fibrillation. J Cardiovasc Electrophysiol 1999;10:461–71. By permission of Futura Publishing Company).

View larger version (22K): [in a new window]   Figure 5 Type of atrial fibrillation (Afib) at diagnosis and at last follow-up in Olmsted County patients age 60 years or younger and those older than 60 years. Among younger patients, 20% never had a recurrence, 58% had recurrent disease, and only 22% had chronic atrial fibrillation at follow-up. Among older patients, 67% were in chronic Afib at follow-up. (Data from Kopecky et al. [48,50]).