Atrial fibrillation epidemiology and demographics
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Anahita Deylamsalehi, M.D.[2]
Overview
Incidence of atrial fibrillation is approximately less than 0.1% per year in those under 40 years of age. On the other hand incidence rate increases to greater than 1.5% per year in women over 80 age and greater than 2% per year in men over 80 years of age. The atrial fibrillation prevalence in the general population is 0.4%. Prevalence of atrial fibrillation has been estimated to be even more, since many cases of atrial fibrillation remain asymptomatic for a long time. Atrial fibrillation is associated with a 1.5 to 1.9 fold increase in the risk of death. The incidence of atrial fibrillation increases with age (median age of 75 years). Prevalence of atrial fibrillation has been reported to be higher among Caucasians (European ancestry) and it is more common in males compared to females.
Epidemiology and Demographics
Incidence
- Researches have shown that the incidence of atrial fibrillation is approximately less than 0.1% per year in those under 40 years of age. On the other hand incidence rate increases to greater than 1.5% per year in women over 80 age and greater than 2% per year in men over 80 years of age. [1]
- Based on another study the incidence of atrial fibrillation among the US Medicare beneficiaries older than 65 years old has been reported 28.3 per 1,000 person annually.[2][3]
- Other studies demonstrated on European population released the following information regard the incidence of atrial fibrillation:[3][4][5]
- The incidence of atrial fibrillation has been estimated as 0.23 per 1,000 person/years in Iceland.
- The incidence of atrial fibrillation has been estimated as 0.41 per 1,000 person/years in Germany.
- The incidence of atrial fibrillation has been estimated as 0.9 per 1,000 person/years in Scotland.
Prevalence
- The prevalence in the general population is 0.4%.[6]
- The prevalence of atrial fibrillation has been increased during the last decades, due to various causes such as improved diagnostic tools, increased in age average in some populations and higher rate of successful treatment in cardiac patients.[3]
- Prevalence of atrial fibrillation has been estimated to be even more, since many cases of atrial fibrillation remain asymptomatic for a long time.[7]
- Approximately 2.2 million individuals in the United States and 4.5 million in the European Union have atrial fibrillation.[1][8]
Case-fatality rate/Mortality rate
- Atrial fibrillation is associated with a 1.5 to 1.9 fold increase in the risk of death.[1]
- The mortality rate of patients with atrial fibrillation is nearly double that of patients with normal sinus rhythm. This increase is due not only to atrial fibrillation alone but also due to the severity of possible underlying diseases, and is often due to thromboembolic events.[1]
- The administration of medications aimed at rate control alone offers no survival advantage over the use of rate control along with anticoagulation as demonstrated in the AFFIRM trial.[9]
- The following table is a summary regard the increased mortality rate after atrial fibrillation development:[3][2]
| Mortality rate within 30 days of atrial fibrillation development | 10.8 % |
|---|---|
| Mortality rate in first year of atrial fibrillation development | 24.7% |
| Mortality rate within 3 first years of atrial fibrillation development | 42% |
- A study done on Swedish population with 24 years follow up demonstrated the mortality rate is specifically higher within the first 4 months of diagnosis (67%).[10]
Age
- The incidence of atrial fibrillation increases with age.[11][12][13][14][15]
- The prevalence of patients with atrial fibrillation in individuals over the age of 80 is about 10-17%. While only 3.7%–4.2% of patients aged 60–70 year have atrial fibrillation.[3]
- Patients with atrial fibrillation have a median age of 75 years.
- The proportion of patients with atrial fibrillation who are between 65 and 85 years of age is 70%.[16]
Race
- Prevalence of atrial fibrillation has been reported to be higher among Caucasians (European ancestry).[12]
- Important genetic determinants may play a role since the age-adjusted risk of developing atrial fibrillation among African-Americans is less than half that in Caucasians.[17][18] [19]
Gender
- Atrial fibrillation is more common in males compared to females.[3][12]
- The male to female ratio has been reported as 1.2:1 in atrial fibrillation patients.
- There are more elderly women with atrial fibrillation, compared to men which is due to longer life among female patients.[19][20]
Region
The following table is a summary of how rate of atrial fibrillation differs among various regions: [3]
| Regions | Prevalence |
|---|---|
| Italy | 1.9 % |
| England | 1.9 % |
| Iceland | 1.9 % |
| Germany | 2.3 % |
| Sweden | 2.9% |
Developed Countries
In developed countries, the number of patients with atrial fibrillation is likely to increase during the next 50 years, due to the growing proportion of elderly individuals.[21]
Developing Countries
- Prevalence of atrial fibrillation in developing countries has estimated as 0.4 % in female and 0.6% in male populations.[3]
References
- ↑ 1.0 1.1 1.2 1.3 PMID 16908781 (PMID 16908781)
Citation will be completed automatically in a few minutes. Jump the queue or expand by hand - ↑ 2.0 2.1 Piccini JP, Hammill BG, Sinner MF, Jensen PN, Hernandez AF, Heckbert SR; et al. (2012). "Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007". Circ Cardiovasc Qual Outcomes. 5 (1): 85–93. doi:10.1161/CIRCOUTCOMES.111.962688. PMC 3332107. PMID 22235070.
- ↑ 3.0 3.1 3.2 3.3 3.4 3.5 3.6 3.7 Zoni-Berisso M, Lercari F, Carazza T, Domenicucci S (2014). "Epidemiology of atrial fibrillation: European perspective". Clin Epidemiol. 6: 213–20. doi:10.2147/CLEP.S47385. PMC 4064952. PMID 24966695.
- ↑ Murphy NF, Simpson CR, Jhund PS, Stewart S, Kirkpatrick M, Chalmers J; et al. (2007). "A national survey of the prevalence, incidence, primary care burden and treatment of atrial fibrillation in Scotland". Heart. 93 (5): 606–12. doi:10.1136/hrt.2006.107573. PMC 1955558. PMID 17277353.
- ↑ Wilke T, Groth A, Mueller S, Pfannkuche M, Verheyen F, Linder R; et al. (2013). "Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients". Europace. 15 (4): 486–93. doi:10.1093/europace/eus333. PMID 23220354.
- ↑ OSTRANDER LD, BRANDT RL, KJELSBERG MO, EPSTEIN FH (1965). "ELECTROCARDIOGRAPHIC FINDINGS AMONG THE ADULT POPULATION OF A TOTAL NATURAL COMMUNITY, TECUMSEH, MICHIGAN". Circulation. 31: 888–98. PMID 14297523. Unknown parameter
|month=ignored (help) - ↑ Rho RW, Page RL (2005). "Asymptomatic atrial fibrillation". Prog Cardiovasc Dis. 48 (2): 79–87. doi:10.1016/j.pcad.2005.06.005. PMID 16253649.
- ↑ Go AS, Hylek EM, Phillips KA; et al. (2001). "Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study". JAMA. 285 (18): 2370–5. doi:10.1001/jama.285.18.2370. PMID 11343485.
- ↑ Wyse DG, Waldo AL, DiMarco JP, Domanski MJ, Rosenberg Y, Schron EB, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. Dec 5 2002;347(23):1825-33.
- ↑ Miyasaka Y, Barnes ME, Bailey KR, Cha SS, Gersh BJ, Seward JB; et al. (2007). "Mortality trends in patients diagnosed with first atrial fibrillation: a 21-year community-based study". J Am Coll Cardiol. 49 (9): 986–92. doi:10.1016/j.jacc.2006.10.062. PMID 17336723.
- ↑ Allessie MA, Boyden PA, Camm AJ, Kléber AG, Lab MJ, Legato MJ; et al. (2001). "Pathophysiology and prevention of atrial fibrillation". Circulation. 103 (5): 769–77. doi:10.1161/01.cir.103.5.769. PMID 11156892.
- ↑ 12.0 12.1 12.2 Staerk L, Sherer JA, Ko D, Benjamin EJ, Helm RH (2017). "Atrial Fibrillation: Epidemiology, Pathophysiology, and Clinical Outcomes". Circ Res. 120 (9): 1501–1517. doi:10.1161/CIRCRESAHA.117.309732. PMC 5500874. PMID 28450367.
- ↑ Fuster V, Rydén LE, Asinger RW; et al. (2001). "ACC/AHA/ESC guidelines for the management of patients with atrial fibrillation. A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines and Policy Conferences (Committee to develop guidelines for the management of patients with atrial fibrillation) developed in collaboration with the North American Society of Pacing and Electrophysiology". Eur. Heart J. 22 (20): 1852–923. doi:10.1053/euhj.2001.2983. PMID 11601835. Unknown parameter
|month=ignored (help) - ↑ Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM (1994). "Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)". Am. J. Cardiol. 74 (3): 236–41. doi:10.1016/0002-9149(94)90363-8. PMID 8037127.
- ↑ McManus DD, Rienstra M, Benjamin EJ (2012). "An update on the prognosis of patients with atrial fibrillation". Circulation. 126 (10): e143–6. doi:10.1161/CIRCULATIONAHA.112.129759. PMC 3678907. PMID 22949543.
- ↑ Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG (1995). "Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications". Arch. Intern. Med. 155 (5): 469–73. PMID 7864703. Unknown parameter
|month=ignored (help) - ↑ Flegel KM, Shipley MJ, Rose G (1987). "Risk of stroke in non-rheumatic atrial fibrillation". Lancet. 1 (8532): 526–9. Unknown parameter
|month=ignored (help) - ↑ Wolf PA, Abbott RD, Kannel WB (1991). "Atrial fibrillation as an independent risk factor for stroke: the Framingham Study". Stroke. 22 (8): 983–8. PMID 1866765. Unknown parameter
|month=ignored (help) - ↑ 19.0 19.1 Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM (1994). "Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study)". Am. J. Cardiol. 74 (3): 236–41. PMID 8037127. Unknown parameter
|month=ignored (help) - ↑ Kannel WB, Abbott RD, Savage DD, McNamara PM (1983). "Coronary heart disease and atrial fibrillation: the Framingham Study". Am. Heart J. 106 (2): 389–96. PMID 6869222. Unknown parameter
|month=ignored (help) - ↑ Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE (2001). "Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study". JAMA. 285 (18): 2370–5. doi:10.1001/jama.285.18.2370. PMID 11343485. PMID 11343485