Epidemiologic shift and future projections of atrial fibrillation and flutter in North Africa and the Middle East region: A comprehensive Global Burden of Disease analysis.

BACKGROUND: Owing to the limited availability of data pertaining to atrial fibrillation and flutter (AFF) in the North Africa and the Middle East (NAME) region, a systematic analysis of epidemiologic trends is crucial. OBJECTIVE: This study aimed to examine the epidemiologic burden of AFF across the NAME using the Global Burden of Disease 2021 and project trends over the next 10 years. METHODS: Data on age-standardized incidence (ASIR), prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (ASDRs) were retrieved from the Global Burden of Disease study. Temporal trends between 1990 and 2021 were explored using estimated average percentage change (EAPC) and joinpoint regression. Autoregressive integrated moving average forecasting was applied to project future trends until 2031. RESULTS: Across the NAME region, ASIR (EAPC, 0.03) and ASPR (EAPC, 0.10) demonstrated significant upward trends, exclusively among males. ASMR (EAPC, 0.49) and ASDR (EAPC, 0.23) demonstrated a significant upward trend in both sexes. Joinpoint regression revealed higher ASMR and ASDR burden among females. The burden of disability-adjusted life years was lower for the NAME nation than the global disability-adjusted life year rate across all age groups for both 1990 and 2021. The sociodemographic index was positively correlated with ASIR, ASPR, ASMR, and ASDR. Autoregressive integrated moving average projections indicate a probable rise in ASIR, ASMR, and ASPR, but not in ASDR, by 2031. CONCLUSION: Our study demonstrated the growing burden of AFF across the NAME region with clear disparities by sex, geography, and economic status. Compared with males, females continue to have a disproportionate share of AFF-related mortality and disability.