Prevalence and Risk Factors in Indigenous Populations
Relative to the Hispanic and Latino demographics, there is an even
greater need for further research into the effects of cardiac ion
channelopathies in Native American and Aboriginal populations. A 2015
article by Jeffrey Reading highlighted how the shift from the
hunter-gatherer lifestyle in Canadian Aboriginal culture increased the
risk of developing CVD and led to a less physically active population
overall.13 In a 2015 review, Arbour et al. noted that
some Inuit and First Nations communities in Canada exhibit higher rates
of congenital heart malformations and LQTS, highlighting the relevance
of genetic predispositions in specific groups of
Aboriginals.12 A more recent 2023 population-based
cohort study by Eberly et al. involved 220,598 American Indian and
Alaska Native Medicare beneficiaries with a median age of 72.5 years and
found that the prevalence of AF in this population was
9%.11 A systematic scoping review published in 2015
by Katzenellenbogen et al. examined the contemporary studies on AF
epidemiology in the Indigenous populations of Australia, the United
States, and New Zealand but found no clear patterns in the prevalence
and incidence of AF among these populations.9 In a
2022 study, Sanchez et al. discussed that American Indians develop AF at
a higher rate relative to other racial and ethnic groups, and there are
also disparities in administering anticoagulation therapy, rhythm
control strategies, and overall quality of healthcare in this population
(Figure 3 ).34 Similar findings regarding the
prevalence of AF were also demonstrated in a cross-sectional study of
Indigenous Australians compared to non-Indigenous
Australians.35 A 2021 study on implementing AF
screening in a tribal primary care clinic using a mobile single-lead ECG
device showed that among 1,019 screened patients, new AF was diagnosed
in 1.5% compared to 0.3% in the control group that did not undergo
screening. The mean difference was 1.2%, indicating that mobile ECG
screening detected a significantly higher incidence of AF than usual
care, displaying the efficacy of implementing a deliberate AF screening
protocol in Native American healthcare.36