Atrial Fibrillation is the most common sustained cardiac arrhythmia, and is associated with significant impairments in quality of life. Regional variations and challenges in the management of atrial fibrillation are present throughout the Americas. Atrial fibrillation incidence and prevalence varies widely, with significant regional differences in the consequences of atrial fibrillation (disability adjusted life years, and mortality). While the contemporary goals are similar, the management of atrial fibrillation is highly variable across the Americas, driven by regional differences in access to medical services, diagnostics, treatments and technologies, as well as country-specific differences in health-care expenditures. Healthcare policies to address these within and between country barriers will lead to improved care and a reduction in the economic burden of atrial fibrillation. Failure to remediate health inequities will exacerbate the burden of healthcare resources attributed toward the management of this disease.