{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,20]],"date-time":"2026-06-20T00:07:17Z","timestamp":1781914037157,"version":"3.54.5"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,2,19]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Black individuals in the United States experience higher rates of ischemic stroke than other racial groups but have lower rates of clinically apparent atrial fibrillation (\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              ). It is unclear whether blacks truly have less\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              or simply more undiagnosed\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              .\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              We performed a retrospective cohort study using inpatient and outpatient claims from 2009 to 2015 for a 5% nationally representative sample of Medicare beneficiaries. We included patients aged \u226566\u00a0years with at least 1 documented\n              <jats:italic>Current Procedural Terminology<\/jats:italic>\n              code for interrogation of an implantable pacemaker, cardioverter\u2010defibrillator, or loop recorder and no documented history of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              , atrial flutter, or stroke before their first device interrogation. Kaplan\u2013Meier statistics and Cox proportional hazards models were used to examine the association between black race and the composite outcome of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              or atrial flutter while adjusting for age, sex, and vascular risk factors. Among 47\u00a0417 eligible patients, the annual incidence of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              \/atrial flutter was 12.2 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 11.5\u201313.1) per 100\u00a0person\u2010years among blacks and 17.6 (95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 17.4\u201317.9) per 100\u00a0person\u2010years among non\u2010black beneficiaries. After adjustment for confounders, black beneficiaries faced a lower hazard of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              \/atrial flutter than non\u2010black beneficiaries (hazard ratio, 0.75; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 0.70\u20130.80). Despite the lower risk of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              , black patients faced a higher hazard of ischemic stroke (hazard ratio, 1.37; 95%\n              <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n              , 1.22\u20131.53).\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              Among Medicare beneficiaries with implanted cardiac devices capable of detecting atrial rhythm, black patients had a lower incidence of\n              <jats:styled-content style=\"fixed-case\">AF<\/jats:styled-content>\n              despite a higher burden of vascular risk factors and a higher risk of stroke.\n            <\/jats:p>\n          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NC"}],"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":"Elsayed Z.","family":"Soliman","sequence":"additional","affiliation":[{"name":"Department of Epidemiology and Prevention Epidemiological Cardiology Research Center 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"}]},{"given":"Hooman","family":"Kamel","sequence":"additional","affiliation":[{"name":"Clinical and Translational Neuroscience Unit Feil Family Brain and Mind Research Institute Weill Cornell Medical College New York NY"},{"name":"Department of Neurology Weill Cornell Medical College New York 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