Global voices on atrial fibrillation management: Brazil

Abstract

Atrial fibrillation (AF) and stroke are prevalent conditions worldwide, and the AF burden is expected to concentrate in low- and middle-income countries like Brazil. The National Institute for Health and Care Excellence–funded Global Health Research Group on Atrial Fibrillation Management (GHRG-AF) had a Brazilian arm that addressed AF epidemiology and care in Brazil. GHRG-AF analyzed data from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil), a long-term cohort of 15,105 middle-aged adults in Brazil, focused on cardiovascular disease and diabetes. Additionally, the GHRG-AF used data from the Brazilian Study of Stroke Mortality and Morbidity (EMMA) study to understand AF impact on this cohort of 1863 stroke survivors, all admitted to a community hospital. The GHRG-AF also surveyed healthcare practices and the pathways of individuals who live with AF, interviewing health professionals and patients treated in different healthcare units in São Paulo. Despite these multiple approaches, those data were restricted to individuals living in large urban centers. Approximately 70% of the Brazilian territory comprises sparsely populated cities (<10 inhabitants/km²), which, as a group, are home to 15 million individuals. In a new step, the GHRG-AF collaborators aim to improve cardiovascular research capacity in distant locations of the Brazilian Amazon, develop patient-centered protocols, empower community health agents in the region, and intensify collaboration with other research groups in remote parts of the country.