This comprehensive Lancet Seminar provides a state-of-the-art overview of atrial fibrillation, covering its rising global prevalence of 37.6 million affected individuals, the impact of wearable device-based detection, contemporary management strategies including early rhythm control and pulsed field ablation, and integrated AF care pathways.
Atrial fibrillation affects approximately 37·6 million people worldwide, with the prevalence predicted to double over the next 35 years. The ubiquitous use of wearable devices and other technologies with inbuilt diagnostic algorithms allows greater detection of atrial fibrillation among the general public than previously. Atrial fibrillation increases the risk of stroke and thromboembolism, heart failure, and death, and is associated with reductions in quality of life. Patients with atrial fibrillation frequently have comorbidities, and the accumulation of risk factors, including lifestyle factors associated with poorer health outcomes, and increasing age, often adds to the complexity of managing such patients.