Wed Mar 19 12:39:31 UTC 2025: ## Atrial Fibrillation: A Growing, Often Undetected Threat in India

**Thiruvananthapuram, Kerala, March 19, 2025** – Atrial fibrillation (Afib), the most common cardiac arrhythmia, is a growing public health concern in India, particularly in Kerala, according to a recent study. Affecting millions globally, Afib often goes undiagnosed, leading to increased risks of stroke, heart failure, and mortality.

A significant finding from the Kerala AF registry (2016-2021), the largest study on Afib patients in India, reveals suboptimal treatment and care, especially concerning stroke prevention. The study, involving 3,421 patients from 53 hospitals, showed that while a high percentage of patients had risk factors like hypertension and diabetes, only 38.6% received oral anticoagulants for clot prevention. The one-year mortality rate was a concerning 16.48%.

Experts highlight several contributing factors, including physician inertia in prescribing newer, safer anticoagulants, cost considerations, and a shortage of specialists. While newer guidelines emphasize maintaining a normal heart rhythm, implementation remains uneven across the country.

The use of smartwatches with built-in ECG capabilities offers a potential solution for broader screening and long-term monitoring, with the FDA recently qualifying Apple’s Afib detection feature as a medical device. However, the need for increased awareness, patient education, and improved access to treatment, particularly in rural areas, remains crucial. The “Atrial Fibrillation Better Care” (ABC) pathway, emphasizing stroke avoidance, better symptom management, and cardiovascular risk factor optimization, is recommended as a comprehensive approach to managing Afib. Further research and investment are needed to address this growing health crisis.

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