The following section is about non-valvular atrial fibrillation
Patients with non-valvular AF can suffer from palpitations, light-headedness, shortness of breath and chest pain, or they can be asymptomatic. In patients with non-valvular AF, the heart beat can be normalised using medication (e.g. beta-blockers or calcium channel blockers) or a controlled electric shock. Severe cases may require catheter ablation, where a wire is fed into the heart tissue.
Patients with AF are at increased risk of clot formation, due to the reduced movement of blood in the heart. If a clot dislodges and travels to the brain, this can result in a stroke. Patients with AF have around a fivefold higher risk of stroke than people with AF. Stroke patients with AF are also likely to have a worse outcome than stroke patients without AF, in terms of stroke severity, recurrences, functional deficits, cardiac complications and mortality. Patients with AF are therefore often given anticoagulants (e.g. warfarin) to reduce their stroke risk.
Atrial fibrillation usually occurs in patients with other heart or lung conditions, but can also occur in otherwise healthy people.
Atrial fibrillation can occur in presence of the various types of valvular heart diseases (for example, in patients with mitral stenosis or mechanical prosthetic valves); although AF caused by valvular heart diseases is relatively rare. The term ‘non-valvular AF’ is used to describe the majority of cases where rhythm disturbance is not associated with these problems. Patients recruited into GARFIELD-AF had a new diagnosis of ‘non-valvular’ atrial fibrillation.
Prevalence of atrial fibrillation
Up to 2% of the world’s population has AF, with around 8.8 million people in the European Union, 5-6.1 million people in the United States and 8 million people in China suffering from the disease. It is estimated that its prevalence will at least double by 2050 as the global population ages.
Risk factors for non-valvular atrial fibrillation
The likelihood of developing non-valvular AF increases with age. About 70% of AF cases occur in patients between the ages of 65 and 85 years. Approximately 1 in 6 patients with AF over 75 years of age are women.
Recruitment into GARFIELD-AF is now complete.