{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T20:05:12Z","timestamp":1791317112971,"version":"4.3.1"},"reference-count":29,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2016,2,23]]},"abstract":"\n Background<\/jats:title>\n \n Black\n US<\/jats:styled-content>\n residents experience higher rates of ischemic stroke than white residents but have lower rates of clinically apparent atrial fibrillation (\n AF<\/jats:styled-content>\n ), a strong risk factor for stroke. It is unclear whether black persons truly have less\n AF<\/jats:styled-content>\n or simply more undiagnosed\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n We obtained administrative claims data from state health agencies regarding all emergency department visits and hospitalizations in California, Florida, and New York. We identified a cohort of patients with pacemakers, the regular interrogation of which reduces the likelihood of undiagnosed\n AF<\/jats:styled-content>\n . We compared rates of documented\n AF<\/jats:styled-content>\n or atrial flutter at follow\u2010up visits using Kaplan\u2013Meier survival statistics and Cox proportional hazards models adjusted for demographic characteristics and vascular risk factors. We identified 10\u00a0393 black and 91\u00a0380 white patients without documented\n AF<\/jats:styled-content>\n or atrial flutter before or at the index visit for pacemaker implantation. During 3.7 (\u00b11.8) years of follow\u2010up, black patients had a significantly lower rate of\n AF<\/jats:styled-content>\n (21.4%; 95%\n CI<\/jats:styled-content>\n 19.8\u201323.2) than white patients (25.5%; 95%\n CI<\/jats:styled-content>\n 24.9\u201326.0). After adjustment for demographic characteristics and comorbidities, black patients had a lower hazard of\n AF<\/jats:styled-content>\n (hazard ratio 0.91; 95%\n CI<\/jats:styled-content>\n 0.86\u20130.96), a higher hazard of atrial flutter (hazard ratio 1.29; 95%\n CI<\/jats:styled-content>\n 1.11\u20131.49), and a lower hazard of the composite of\n AF<\/jats:styled-content>\n or atrial flutter (hazard ratio 0.94; 95%\n CI<\/jats:styled-content>\n 0.88\u201399).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In a population\u2010based sample of patients with pacemakers, black patients had a lower rate of\n AF<\/jats:styled-content>\n compared with white patients. These findings indicate that the persistent racial disparities in rates of ischemic stroke are likely to be related to factors other than undiagnosed\n AF<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.115.002492","type":"journal-article","created":{"date-parts":[[2018,9,14]],"date-time":"2018-09-14T13:11:36Z","timestamp":1536930696000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":30,"title":["Rates of Atrial Fibrillation in Black Versus White Patients With Pacemakers"],"prefix":"10.1161","volume":"5","author":[{"given":"Hooman","family":"Kamel","sequence":"first","affiliation":[{"name":"Department of Neurology and Feil Family Brain and Mind Research Institute, Weill Cornell Medical College, New York, NY"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dawn O.","family":"Kleindorfer","sequence":"additional","affiliation":[{"name":"Department of Neurology, University of Cincinnati, OH"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prashant D.","family":"Bhave","sequence":"additional","affiliation":[{"name":"Division of Cardiology, University of Iowa Carver College of Medicine, Iowa City, IA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mary","family":"Cushman","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Pathology, Cardiovascular Research Institute, University of Vermont, Burlington, VT"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily B.","family":"Levitan","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, University of Alabama at Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Howard","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, University of Alabama at Birmingham, AL"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Epidemiological Cardiology Research Center, Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston\u2010Salem, NC"},{"name":"Department of Internal Medicine\u2010Cardiology, Wake Forest School of Medicine, Winston\u2010Salem, NC"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.5888\/pcd11.140138"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/cir.0000000000000152"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.002449"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.108.534735"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2009.05.010"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.110.958306"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjmed.2009.05.019"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.12085"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.285.18.2370"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2003.09.035"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/jce.12066"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.109.573907"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2188\/jea.JE20081032"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.111.000691"},{"key":"e_1_3_3_16_2","unstructured":"U.S. Census Bureau . 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