AFib rates continue to rise, especially among older patients

Atrial fibrillation (AFib) rates increased significantly from 2006 to 2018, according to a new study published in JAMA Network Open. The change was especially evident in patients 85 years old and older.

The study’s authors noted that “the community and clinical burdens of AFib” have been on the rise in recent years.

“Multiple explanations have been posited for the AFib increase, including an aging population, prolonged survival of individuals with cardiac conditions that predispose them to AFib, and an increasing prevalence of AFib risk factors, such as obesity and hypertension, in the at-risk populations,” wrote lead author Brent A. Williams, PhD, Geisinger Health System in Danville, Pennsylvania, and colleagues. “Moreover, some authors have perceived increased attention being directed to AFib in recent years—commonly attributed to the introduction of new anticoagulants for stroke prevention—that may be increasing the propensity to document AFib clinically, especially as a secondary diagnosis.”

To track this trend more closely, Williams et al. explored electronic medical record data from an entire health system in Pennsylvania. The study covered more than 500,000 patients with no prior documentation of AFib. The mean patient age at baseline was 47 years old, and 54.9% of the patients were women.

Overall, the team found that AFib incidence rates increased approximately 3% per year from 2006 to 2018. Among at-risk patients, cases of high BMIs and hypertension also increased during the same time. A rise in short-term electrocardiography (ECG) utilization also seems to have contributed to the overall increase, though no change was evident in long-term ECG monitoring.

One key finding from the team’s work was that AFib cases were not more common among patients with a history of heart failure, coronary artery disease, myocardial infarction or coronary bypass surgery. This detail, the authors emphasized, contradicts the hypothesis that AFib is on the rise because more patients are living with cardiac disorders.

Reviewing the data, Williams and colleagues did note that healthcare providers should pay close attention to this ongoing trend. As BMIs continue to rise and hypertension diagnoses become more common, it seems likely that AFib could follow a similar trajectory.

Click here for the full study from JAMA Network Open.