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Journal of Interventional Cardiac Electrophysiology
Erschienen in:

13.10.2022 | Review

Racial, ethnic, and sex disparities in atrial fibrillation management: rate and rhythm control

verfasst von: Sofia E. Gomez, Muhammad Fazal, Julio C. Nunes, Shayena Shah, Alexander C. Perino, Sanjiv M. Narayan, Kamala P. Tamirisa, Janet K. Han, Fatima Rodriguez, Tina Baykaner

Erschienen in: Journal of Interventional Cardiac Electrophysiology | Ausgabe 5/2023

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Abstract

Background

Atrial fibrillation (AF) affects around 6 million Americans. AF management involves pharmacologic therapy and/or interventional procedures to control rate and rhythm, as well as anticoagulation for stroke prevention. Different populations may respond differently to distinct management strategies. This review will describe disparities in rate and rhythm control and their impact on outcomes among women and historically underrepresented racial and/or ethnic groups.

Methods

This is a narrative review exploring the topic of sex and racial and/or ethnic disparities in rate and rhythm management of AF. We describe basic terminology, summarize AF epidemiology, discuss diversity in clinical research, and review landmark clinical trials.

Results

Despite having higher rates of traditional AF risk factors, Black and Hispanic adults have lower risk of AF than non-Hispanic White (NHW) patients, although those with AF experience more severe symptoms and report lower quality-of-life scores than NHW patients with AF. NHW patients receive antiarrhythmic drugs, cardioversions, and invasive therapies more frequently than Black and Hispanic patients. Women have lower rates of AF than men, but experience more severe symptoms, heart failure, stroke, and death after AF diagnosis. Women and people from diverse racial and ethnic backgrounds are inadequately represented in AF trials; prevalence findings may be a result of underdetection.

Conclusion

Race, ethnicity, and gender are social determinants of health that may impact the prevalence, evolution, and management of AF. This impact reflects differences in biology as well as disparities in treatment and representation in clinical trials.
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Metadaten
Titel
Racial, ethnic, and sex disparities in atrial fibrillation management: rate and rhythm control
verfasst von
Sofia E. Gomez
Muhammad Fazal
Julio C. Nunes
Shayena Shah
Alexander C. Perino
Sanjiv M. Narayan
Kamala P. Tamirisa
Janet K. Han
Fatima Rodriguez
Tina Baykaner
Publikationsdatum
13.10.2022
Verlag
Springer US
Erschienen in
Journal of Interventional Cardiac Electrophysiology / Ausgabe 5/2023
Print ISSN: 1383-875X
Elektronische ISSN: 1572-8595
DOI
https://doi.org/10.1007/s10840-022-01383-x

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