Epidemiology of Atrial Fibrillation: Trends, Insights, and Global Challenges

Topic Information

Dear Colleagues,

Atrial fibrillation (AF) affects over 60 million individuals worldwide and is associated with a significantly increased risk of stroke, heart failure, and all-cause mortality. With the global aging of the population, both the prevalence and healthcare burden of AF are steadily increasing, underscoring the urgent need for optimized strategies for its prevention, early detection, and management. Historically, AF diagnosis was reliant on documentation via standard 12-lead electrocardiography (ECG). However, the diagnostic landscape has evolved with the advent of continuous rhythm monitoring technologies, including wearable devices employing optical sensors and artificial intelligence-based algorithms. These innovations facilitate earlier detection and the timely initiation of therapy, particularly anticoagulation, to mitigate thromboembolic risk. Contemporary AF management has shifted toward an integrated, patient-centered model. Multidisciplinary care teams address modifiable risk factors and comorbidities while tailoring treatment strategies, which include rate and rhythm control through pharmacological therapy, electrical cardioversion, and catheter ablation. The recent introduction of pulsed field ablation (PFA), a novel non-thermal energy modality, offers enhanced procedural safety and efficiency and may represent a paradigm shift in interventional therapy. This Special Topic examines the global impact of AF and reviews emerging innovations in diagnostics, pharmacotherapy, and individualized care models aimed at improving clinical outcomes and reducing stroke incidence.

Dr. Tomer Ziv-Baran
Dr. Moshe Katz
Topic Editors

Keywords

Participating Journals

Journal Name	Impact Factor	CiteScore	Launched Year	First Decision (median)	APC
Hearts hearts	-	-	2020	19 Days	CHF 1000	Submit
Journal of Cardiovascular Development and Disease jcdd	2.3	3.7	2014	28.8 Days	CHF 2700	Submit
Journal of Clinical Medicine jcm	2.9	5.2	2012	17.7 Days	CHF 2600	Submit

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All Hearts JCDD JCM

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Open AccessArticle

Long-Term Clinical Outcomes of Left Atrial Appendage Closure in Patients with Left Atrial Appendage Thrombus

by Moshe Katz, Rotem Nahmias Oz, Eias Massalha, Avi Sabag, Eyal Nof, Israel Barbash, Paul Fefer, Victor Guetta and Roy Beinart

J. Clin. Med. 2025, 14(21), 7589; https://doi.org/10.3390/jcm14217589 - 26 Oct 2025

Viewed by 825

Abstract

Background: Patients with atrial fibrillation (AF) who have a high bleeding risk or contraindications to anticoagulation may be candidates for left atrial appendage closure (LAAC). However, the presence of a thrombus in the left atrial appendage (LAA) is generally considered a contraindication [...] Read more.

Background: Patients with atrial fibrillation (AF) who have a high bleeding risk or contraindications to anticoagulation may be candidates for left atrial appendage closure (LAAC). However, the presence of a thrombus in the left atrial appendage (LAA) is generally considered a contraindication to the procedure. While the feasibility and short-term safety of LAAC in patients with pre-existing LAA thrombus has been reported, data on long-term outcomes remain limited. Objective: To assess the long-term clinical outcomes of AF patients undergoing LAAC in the presence of an LAA thrombus. Methods: This retrospective, single-center registry included all AF patients who underwent LAAC between June 2010 and April 2024. Patients were stratified based on the presence or absence of LAA thrombus at the time of the procedure. The primary endpoint was a 5-year composite of stroke, systemic embolism, or all-cause mortality. Results: A total of 403 patients underwent LAAC, of whom 24 (6%) had an LAA thrombus at the time of the procedure. During a median follow-up of 3.9 years, the primary endpoint occurred in 116 patients: 110 events (41%) in the no-thrombus group and 6 events (38%) in the thrombus group. There was no statistically significant difference in major adverse cardiovascular events (MACE) between groups (log-rank p = 0.862). Conclusions: LAAC may be performed safely in selected patients with distal LAA thrombus, with long-term outcomes comparable to those without thrombus. Full article

(This article belongs to the Topic Epidemiology of Atrial Fibrillation: Trends, Insights, and Global Challenges)

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