Atrial Fibrillation in Singapore and Malaysia: Current Trends and Future Prospects

Abstract

Atrial fibrillation (AF) imposes substantial burdens of morbidity and impaired health‐related quality of life, and significantly increases sufferers' risk of having a cardiovascular event, in particular a stroke. Prevalence of AF in Asia and the associated healthcare costs are likely to have been underestimated and are expected to increase due to greater awareness, population ageing and increasing prevalence of associated risk factors and comorbidities. The AF management paradigm is shifting from a conventional focus on achieving heart rate or rhythm control, towards endeavouring to use the safest agents available to reduce patients' symptoms and improve their quality of life and cardiovascular outcomes. No new anti‐AF drugs have been introduced for decades and existing pharmacotherapeutic modalities have potentially serious side effects as well as sub‐optimal efficacy in converting to and maintaining normal sinus rhythm and preventing recurrence. There is an unmet need for better anti‐arrhythmic drugs that are well tolerated, efficacious, cost‐effective and have a more favourable safety profile than current options. Although the perfect agent remains to be discovered, some promising new anti‐arrhythmic drugs have the potential to overcome certain limitations of established approaches to AF management.

Radiofrequency ablation of atrial fibrillation: A 14 years’ experience at a tertiary care center in Thailand

“…17 Despite the fact that AF ablation is a standard treatment, there were only a few studies reported the success rate in the Asian population and even less with Southeast Asian region with only two reports from Singapore and Malaysia. 18…”

“…17 Despite the fact that AF ablation is a standard treatment, there were only a few studies reported the success rate in the Asian population and even less with Southeast Asian region with only two reports from Singapore and Malaysia. 18 Asian ethnicity also tends to have lower body weight and BMI compared to other ethnicity. A higher BMI is associated with a lower chance of freedom of AF.…”

Patient perspectives of the Self-management and Educational Technology tool for Atrial Fibrillation (SETAF): A mixed-methods study in Singapore

“…Atrial fibrillation (AF) is the most common cardiac arrythmia and is associated with costly cardiovascular morbidity such as stroke and heart failure [6][7][8]. The need for long term adherence to complex therapies, fluctuating symptoms and increased risk of adverse outcomes make AF a challenging condition for patients to manage [9].…”

“…Due to the sporadic and highly variable nature of disease, traditional healthcare models of pre-scheduled appointments with health providers may be poorly suited to meet the unpredictable and potentially urgent needs of AF patients [10]. With greater awareness, ageing populations and the rise in predisposing risk factors such as hypertension and diabetes mellitus, the prevalence of AF and its associated healthcare costs are expected to increase substantially [6,7]. This highlights the importance of adopting new strategies to optimize the management of this growing epidemic.…”

Outcomes of Patients Presenting with Primary or Secondary Atrial Fibrillation with Rapid Ventricular Rate to the Emergency Department

“…5 However, this number has increased over recent years due to population ageing, increasing prevalence of comorbidities (diabetes, hypertension, ischaemic heart disease) and increased awareness and diagnosis of AF. 6 AF affects the quality of life. It increases the risk of stroke and heart failure; and overall mortality rate is approximately double compared to patients in normal sinus rhythm.…”