Views & Reviews From the Frontline

Bad medicine: atrial fibrillation

BMJ 2013; 347 doi: http://dx.doi.org/10.1136/bmj.f4910 (Published 07 August 2013) Cite this as: BMJ 2013;347:f4910
  1. Des Spence, general practitioner, Glasgow
  1. destwo{at}yahoo.co.uk

General practitioners are the canaries of epidemiology, monitoring large cohorts of patients over many decades and observing changes in illness trends long before research does. Consider atrial fibrillation (AF), with a reported lifetime risk of 25% for men and 17% for women, the Framingham study found.1 And this is an underestimate for paroxysmal AF, which apparently carries the same risk of stroke but is often missed.

The annual risk of stroke in people with AF is 3-4%.2 As AF is so prevalent, it follows that a large proportion of the population will have a stroke. …

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