{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,17]],"date-time":"2026-10-17T20:19:33Z","timestamp":1792268373337,"version":"4.4.0"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,4]],"date-time":"2026-03-04T00:00:00Z","timestamp":1772582400000},"content-version":"vor","delay-in-days":1,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82270337"],"award-info":[{"award-number":["82270337"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82470333"],"award-info":[{"award-number":["82470333"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82300357"],"award-info":[{"award-number":["82300357"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Chinese Society of Cardiology\u2019s Foundation","award":["CSCF2024B02"],"award-info":[{"award-number":["CSCF2024B02"]}]},{"DOI":"10.13039\/501100004735","name":"Hunan Provincial Natural Science Foundation of China","doi-asserted-by":"crossref","award":["2021JJ30033"],"award-info":[{"award-number":["2021JJ30033"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/501100004735","name":"Hunan Provincial Natural Science Foundation of China","doi-asserted-by":"crossref","award":["2023JJ30791"],"award-info":[{"award-number":["2023JJ30791"]}],"id":[{"id":"10.13039\/501100004735","id-type":"DOI","asserted-by":"crossref"}]},{"name":"Key Project of Hunan Provincial Science and Technology Innovation","award":["2024JK2119"],"award-info":[{"award-number":["2024JK2119"]}]},{"name":"Clinical Medical Technology Innovation Guidance"},{"name":"Hunan Science and Technology Agency","award":["2021SK53519"],"award-info":[{"award-number":["2021SK53519"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>The burden of atrial fibrillation and atrial flutter (AF\/AFL) has increased, but age-specific patterns across World Bank income levels (WBILs) remain unclear.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results<\/jats:title>\n                    <jats:p>Using the Global Burden of Disease 2023 estimates, we assessed age- and WBIL-stratified trends in prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for AF\/AFL from 1990 to 2023, employing age\u2013period\u2013cohort analysis and joinpoint regression. Mortality attributable to six modifiable risk factors was quantified based on comparative risk assessment estimates. Projections of AF\/AFL burden for 2024\u201348 were generated using Bayesian age\u2013period\u2013cohort models. In 2023, AF\/AFL affected 58.99\u202fmillion prevalent cases, 5.02 million incident cases, 376 862 deaths, and 9.26 million DALYs, with the absolute burden concentrated in adults aged \u2265 65 years. From 1990 to 2023, age-standardized prevalence (ASPR) and incidence rate (ASIR) increased, while mortality rate (ASMR) and disability-adjusted life year rate (ASDR) remained stable. High-income countries showed increases across all metrics, upper-middle-income countries had rising ASPR\/ASIR and decreasing ASMR\/ASDR, and lower-middle- and low-income countries showed consistent increases across all metrics. Among younger (30\u201344 years) and middle-aged (45\u201364 years) adults, all metrics increased, while in older adults, only ASPR rose. High systolic blood pressure was the leading attributable risk factor, with larger contributions from high body mass index, smoking, and alcohol use in younger and middle-aged adults. Projections indicated modest declines in ASPR, stable ASIR, and increasing ASMR\/ASDR through 2048.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Despite the concentrated burden in older adults, mortality- and disability-related burden is rising in younger and middle-aged populations, with significant variation across WBILs.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/europace\/euag036","type":"journal-article","created":{"date-parts":[[2026,2,28]],"date-time":"2026-02-28T12:51:03Z","timestamp":1772283063000},"source":"Crossref","is-referenced-by-count":9,"title":["Burden and age-specific trends of atrial fibrillation\/atrial flutter from 1990 to 2023: a growing challenge among younger and middle-aged adults"],"prefix":"10.1093","volume":"28","author":[{"given":"Siyuan","family":"Tan","sequence":"first","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zixi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-6696-4730","authenticated-orcid":false,"given":"Qiuzhen","family":"Lin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tao","family":"Tu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiayi","family":"Zhu","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-9215-6073","authenticated-orcid":false,"given":"Gaoming","family":"Zeng","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1936-8406","authenticated-orcid":false,"given":"Fanqi","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kangrong","family":"Li","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Second Xiangya Hospital, Central South University , Changsha City, 139 Renmin Road, Furong District, 410011 Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9023-5211","authenticated-orcid":false,"given":"Yongguo","family":"Dai","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Xiangya Hospital, Central South University , Changsha City, Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-8547-9491","authenticated-orcid":false,"given":"Jiabao","family":"Zhou","sequence":"additional","affiliation":[{"name":"The First Detention Area, Tanzhou Prison of Hunan Province , Changsha City, Hunan Province ,","place":["People\u2019s Republic of China"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cancan","family":"Wang","sequence":"additional","affiliation":[{"name":"The First Detention Area, Central Hospital of Hunan Provincial Prison Administration , Changsha City, Hunan Province 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