Atrial fibrillation

Atrial fibrillation affects approximately 37·6 million people worldwide, with the prevalence predicted to double over the next 35 years. The ubiquitous use of wearable devices and other technologies with inbuilt diagnostic algorithms allows greater detection of atrial fibrillation among the general public than previously. Atrial fibrillation increases the risk of stroke and thromboembolism, heart failure, and death, and is associated with reductions in quality of life. Patients with atrial fibrillation frequently have comorbidities, and the accumulation of risk factors, including lifestyle factors associated with poorer health outcomes, and increasing age, often adds to the complexity of managing such patients. All major clinical guidelines advocate that stroke prevention, symptom relief, identification of risk factors, and optimisation of risk factor management, incorporated into an integrated care approach, with multidisciplinary input as required, are essential elements of atrial fibrillation management. Avoidance of stroke with oral anticoagulation remains the default for most patients with atrial fibrillation and, more recently, catheter ablation has been reconsidered as an initial treatment option for symptom relief. The dynamic nature of risk factors requires early identification and appropriate management of new and existing risk factors to optimise atrial fibrillation care. Patient-centred care and better health literacy can empower patients to take a more active role in their atrial fibrillation management.