The Europe–Asia-Pacific Divide in Atrial Fibrillation Management: Evidence, Practice, and Policy

Atrial fibrillation (AF) affects approximately 60 million people worldwide, and Europe and the Asia-Pacific region together carry most of that burden. This state-of-the-art review compares the two regions across six domains: epidemiology and risk factors, lifestyle and comorbidity management, stroke prevention, rhythm control and catheter ablation, digital health and AI-ECG, and health system infrastructure and policy. Practice diverges in all six. European management follows European Society of Cardiology guidelines, whereas Asia-Pacific region care varies across socioeconomic settings and rests on population-scale evidence, with region-wide guidance so far limited to topic-specific Asia Pacific Heart Rhythm Society (APHRS) consensus statements until the first APHRS guideline appears in 2026. Anticoagulation gaps have narrowed in both regions, yet disparities in financing, electrophysiology capacity, and digital access persist, and differences within each region rival those between them. Closing these gaps requires region-specific, resource-adapted strategies and mutual adoption of evidence generated in each region.