Ethnicity and Atrial Fibrillation: A Counterintuitive Phenomenon

Atrial fibrillation, the arrhythmia most frequently encountered in clinical practice, is currently responsible for one third of all ischemic strokes. According to the Global Burden of Disease Study, the age-adjusted prevalence of AF is lower in low- and middle-income countries when compared to wealthy nations. Furthermore, despite the generally higher burden of most primary AF risk factors in ethnic minorities, epidemiology studies have consistently shown that AF prevalence is lower among individuals belonging to ethnic minorities than among individuals with European ancestry. The discordance between the higher AF risk factor burden and the lower incidence and prevalence of AF was seen as a “paradoxical relationship.”