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There is vast literature on specific racial and ethnic groups being underserved in health care. We aim to determine whether these groups are also underrepresented in clinical trials. As atrial fibrillation represents the most widely studied arrhythmic condition, we have focused on this condition to determine patterns of racial-ethnic representation. We also determined whether atrial fibrillation-related research scales are available in common languages. We systematically reviewed 85 randomized atrial fibrillation clinical trials (RCT), encompassing 2 546 351 participants from January 2011 to May 2021. To select the trials, we used ClinicalTrials. gov, using the advance search function. We included completed interventional studies, with enrollment limited to the United States, available results, and in which atrial fibrillation was the main condition studied. We could not address dual enrollment or overlap among the studies …