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PubMed was queried for entries on AF and rurality: (\u201catrial fibrillation\u201d OR \u201catrial flutter\u201d) AND (\u201crural\u201d OR \u201curban\u201d OR \u201crurality\u201d OR \u201cmetro\u201d OR \u201cmetropolitan\u201d) AND (\u201cunited states\u201d OR \u201cUS\u201d OR \u201cU.S.\u201d) published up to September 24, 2023. Anticoagulation, rhythm control, settings of care, outcomes, and all\u2010cause mortality were reviewed in relevant studies. The search identified 395 total articles. After screening, 14 relevant articles were included in the review. These studies ranged from 1993 to 2020 and analyzed approximately 41.7\u2009million AF patient encounters. The use of catheter ablation for AF per electrophysiologist was similar across the rural\u2013urban spectrum. Patients with AF and rural residence were less likely to receive a direct oral anticoagulant and more likely to remain on warfarin (relative risk, 0.90 [95% CI, 0.88\u20130.92]). Patients in rural communities were less likely to receive non\u2010emergent AF care (odds ratio [OR], 0.96 [95% CI, 0.93\u20130.98]). In\u2010hospital mortality for patients with AF admitted to rural hospitals was higher than urban hospitals (OR, 1.19 [95% CI, 1.01\u20131.39)]. Measurable differences exist in both treatments and outcomes of patients with AF between rural and urban settings in the United States. These differences should inform future investigations and strategies to improve health in people with AF.<\/jats:p>","DOI":"10.1161\/jaha.124.036899","type":"journal-article","created":{"date-parts":[[2025,3,3]],"date-time":"2025-03-03T07:21:26Z","timestamp":1740986486000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Care for Atrial Fibrillation and Outcomes in Rural Versus Urban Communities in the United States: A Systematic and Narrative Review"],"prefix":"10.1161","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9548-6194","authenticated-orcid":false,"given":"Anthony L.","family":"Lin","sequence":"first","affiliation":[{"name":"Duke University Health System","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelli","family":"Allen","sequence":"additional","affiliation":[{"name":"Durham Veterans Affairs Medical Center","place":["Durham, USA"]},{"name":"University of North Carolina Chapel Hill","place":["Chapel Hill, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4353-4507","authenticated-orcid":false,"given":"Jorge A.","family":"Gutierrez","sequence":"additional","affiliation":[{"name":"Duke University Health System","place":["Durham, USA"]},{"name":"Durham Veterans Affairs Medical Center","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0772-2404","authenticated-orcid":false,"given":"Jonathan P.","family":"Piccini","sequence":"additional","affiliation":[{"name":"Duke University Health System","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4613-582X","authenticated-orcid":false,"given":"Zak","family":"Loring","sequence":"additional","affiliation":[{"name":"Duke University Health System","place":["Durham, USA"]},{"name":"Durham Veterans Affairs Medical Center","place":["Durham, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.0000140263.20897.42"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.113.005119"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.105.595140"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs469"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/aje\/155.9.819"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.110.958165"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000753"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41569-021-00561-0"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.10.045"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1161\/JAHA.120.018026"},{"key":"e_1_3_1_12_2","first-page":"45","article-title":"Quality of care and patient outcomes in critical access rural hospitals","volume":"306","author":"Joynt KE","year":"2011","unstructured":"Joynt KE, Harris Y, Orav EJ, Jha AK. 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