ArticlePloS one2018
Estimated prevalence of undiagnosed atrial fibrillation in the United States.
Article in PloS one, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 93 papers, 3 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
93 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Global, regional, and national burden of heart failure associated with atrial fibrillation.BMC cardiovascular disorders · 2023Pooled it
- Accuracy of Smartphone Camera Applications for Detecting Atrial Fibrillation: A Systematic Review and Meta-analysis.JAMA network open · 2020Pooled it
- Lead-I ECG for detecting atrial fibrillation in patients with an irregular pulse using single time point testing: a systematic review and economic evaluation.Health technology assessment (Winchester, England) · 2020Pooled it
- Cardiac symptom burden and arrhythmia recurrence drives digital health use: results from the iHEART randomized controlled trial.European journal of cardiovascular nursing · 2022Trial
- Trial
- Magnetic Tracking and Electrocardiography-Guided Tip Confirmation System Versus Fluoroscopy for Placement of Peripherally Inserted Central Catheters: A Randomized, Noninferiority Comparison.Cardiovascular and interventional radiology · 2020Trial
- Large-Scale Assessment of a Smartwatch to Identify Atrial Fibrillation.The New England journal of medicine · 2019Trial
- Article
- Evaluation of a Consumer Wearable Smartwatch for Cardiac Interval Measurement in Healthy Adults: Cross-Sectional Method Comparison Study.JMIR formative research · 2026Article
- Recurrence or persistence of atrial fibrillation is associated with frailty and adverse outcomes: the SAGE-AF cohort study.BMC geriatrics · 2026Article
- Associations of chronic pain and genetic risks with incident atrial fibrillation: a prospective cohort study.BMC cardiovascular disorders · 2026Article
- Artificial Intelligence-Enhanced Electrocardiography for Predicting Paroxysmal Atrial Fibrillation From Sinus Rhythm: Impact of Data Integration Across Institutions and Devices.Annals of noninvasive electrocardiology : the official journal of the International Society for Holter and Noninvasive Electrocardiology, Inc · 2026Article
- Artificial Intelligence-Enabled Electrocardiography for Preoperatively Detecting Atrial Fibrillation and Mortality Risk in Patients with Sinus Rhythm.International journal of medical sciences · 2026Article
- Global, regional, and national burden of atrial fibrillation and atrial flutter in the working-age population from 1990 to 2021: A systematic analysis based on 2021 global burden of disease data.American journal of preventive cardiology · 2025Article
- Artificial intelligence-enabled sinus electrocardiograms for the detection of paroxysmal atrial fibrillation benchmarked against the CHARGE-AF score.European heart journal. Digital health · 2025Article
- AI assisted focused cardiac ultrasound in preventive cardiology - a perspective.NPJ cardiovascular health · 2025Review
- Clinical utility of dynamic chest radiography as an auxiliary tool for atrial fibrillation detection in heart failure: a pilot study.BMC cardiovascular disorders · 2025Article
- Multidiagnostic chest-worn patch to detect obstructive sleep apnea and cardiac arrhythmias.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2025Article
- Domestic water hardness, genetic risk, and distinct phenotypes of cardiovascular disease.Environmental health : a global access science source · 2025Article
- 2025 Heart Disease and Stroke Statistics: A Report of US and Global Data From the American Heart Association.Circulation · 2025Review
33 more citing papers are in PubMed but not listed here.
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionAs atrial fibrillation (AF) is often asymptomatic, it may remain undiagnosed until or even after development of complications, such as stroke. Consequently the observed prevalence of AF may underestimate total disease burden.
methodsTo estimate the prevalence of undiagnosed AF in the United States, we performed a retrospective cohort modeling study in working age (18-64) and elderly (≥65) people using commercial and Medicare administrative claims databases. We identified patients in years 2004-2010 with incident AF following an ischemic stroke. Using a back-calculation methodology, we estimated the prevalence of undiagnosed AF as the ratio of the number of post-stroke AF patients and the CHADS2-specific stroke probability for each patient, adjusting for age and gender composition based on United States census data.
resultsThe estimated prevalence of AF (diagnosed and undiagnosed) was 3,873,900 (95%CI: 3,675,200-4,702,600) elderly and 1,457,100 (95%CI: 1,218,500-1,695,800) working age adults, representing 10.0% and 0.92% of the respective populations. Of these, 698,900 were undiagnosed: 535,400 (95%CI: 331,900-804,400) elderly and 163,500 (95%CI: 17,700-400,000) working age adults, representing 1.3% and 0.09% of the respective populations. Among all undiagnosed cases, 77% had a CHADS2 score ≥1, and 56% had CHADS2 score ≥2.
conclusionsUsing a back-calculation approach, we estimate that the total AF prevalence in 2009 was 5.3 million of which 0.7 million (13.1% of AF cases) were undiagnosed. Over half of the modeled population with undiagnosed AF was at moderate to high risk of stroke.
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