OBJECTIVES: To measure the prevalence of atrial fibrillation (AF) and its subtypes worldwide, and forecast changes in the diagnosed prevalent cases.

METHODS: We performed a global systematic search of published studies and other data sources reporting the diagnosed prevalence of AF, as well as any factors that may change its prognosis or likelihood of diagnosis over time or between countries. Our forecast model accounts for obesity by calculating population attributable risk (PAR) of obesity for AF based on the relative risk of developing AF at country specific, age-, and gender-specific. AF prevalence was estimated for each year over the forecast period by applying the obesity PAR and the percentage change in obesity to the base year of the country specific source. For countries where we did not identify robust population-based studies that met our disease definition, we extrapolated to derive country-, age-, and gender-specific AF prevalence estimates. We classify the diagnosed prevalent cases of AF by subtypes, paroxysmal, persistent, and permanent AF.

RESULTS: We provide a snapshot and forecast of the worldwide prevalence which showed a notable rise in all countries. In 2018, there will be an estimated 37 million diagnosed prevalent cases of AF worldwide. In the mature markets (the United States, France, Germany, Italy, Spain, the United Kingdom, and Japan), we estimate 13.2 million diagnosed prevalent cases of AF in 2018, representing 36% of the global total. Asia-Pacific contributes to 39% to the total AF cases globally as compared to Europe which contributes to 43%. Growth in the number of diagnosed prevalent cases from 2018-2028 will be greater across lower-income countries (43%), than across high-income countries (23%).

CONCLUSIONS: Our estimates demonstrate that obesity increased the risk of developing AF in general population. Globally, there will be 180,400 more AF cases due to an increase in obesity.