Atrial fibrillation epidemiology and demographics: Difference between revisions

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==Epidemiology and Demographics==
==Epidemiology and Demographics==
===Age===
The incidence of atrial fibrillation increases with age. The prevalence in individuals over the age of 80 is about 8%.<ref>{{cite journal |author=Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM |title=Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study) |journal=Am. J. Cardiol. |volume=74 |issue=3 |pages=236–41 |year=1994 |pmid=8037127|doi=10.1016/0002-9149(94)90363-8}}</ref> Important genetic determinants may play a role in so far as the age-adjusted risk of developing atrial fibrillation among African-Americans is less than half that in Caucasians. <ref name="pmid">{{cite journal |author=Flegel KM, Shipley MJ, Rose G |title=Risk of stroke in non-rheumatic atrial fibrillation |journal=Lancet |volume=1 |issue=8532 |pages=526–9 |year=1987 |month=March |pmid= |doi= |url=http://linkinghub.elsevier.com/retrieve/pii/S0140-6736(87)90174-7}}</ref><ref name="pmid1866765">{{cite journal |author=Wolf PA, Abbott RD, Kannel WB |title=Atrial fibrillation as an independent risk factor for stroke: the Framingham Study |journal=Stroke |volume=22 |issue=8 |pages=983–8 |year=1991 |month=August |pmid=1866765 |doi= |url=http://stroke.ahajournals.org/cgi/pmidlookup?view=long&pmid=1866765}}</ref> <ref name="pmid8037127">{{cite journal |author=Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM |title=Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study) |journal=Am. J. Cardiol. |volume=74 |issue=3 |pages=236–41 |year=1994 |month=August |pmid=8037127 |doi= |url=}}</ref> The presence of atrial fibrillation often reflects the presence of underlying cardiac or lung disease.  Indeed, the proportion of patients with lone atrial fibrillation, (that is those patients with atrial fibrillation in whom there is no cardiac or lung disease history) is low at about 12% of cases. <ref name="pmid3627174">{{cite journal |author=Kopecky SL, Gersh BJ, McGoon MD, ''et al'' |title=The natural history of lone atrial fibrillation. A population-based study over three decades |journal=N. Engl. J. Med. |volume=317 |issue=11 |pages=669–74 |year=1987 |month=September |pmid=3627174 |doi= |url=}}</ref><ref name="pmid8037127">{{cite journal |author=Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM |title=Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study) |journal=Am. J. Cardiol. |volume=74 |issue=3 |pages=236–41 |year=1994 |month=August |pmid=8037127 |doi= |url=}}</ref><ref name="pmid13160271">{{cite journal |author=EVANS W, SWANN P |title=Lone auricular fibrillation |journal=Br Heart J |volume=16 |issue=2 |pages=189–94 |year=1954 |month=April |pmid=13160271 |pmc=479515 |doi= |url=http://heart.bmj.com/cgi/pmidlookup?view=long&pmid=13160271}}</ref><ref name="pmid4068186">{{cite journal |author=Brand FN, Abbott RD, Kannel WB, Wolf PA |title=Characteristics and prognosis of lone atrial fibrillation. 30-year follow-up in the Framingham Study |journal=JAMA |volume=254 |issue=24 |pages=3449–53 |year=1985 |month=December |pmid=4068186 |doi= |url=}}</ref> Patients with atrial fibrillation tend to be older with a median age of 75 years.  The proportion of patients with atrial fibrillation who are between 65 and 85 years of age is 70%, and females predominate in the very elderly (60% of atrial fibrillation patients over the age of 75 are women).<ref name="pmid7864703">{{cite journal |author=Feinberg WM, Blackshear JL, Laupacis A, Kronmal R, Hart RG |title=Prevalence, age distribution, and gender of patients with atrial fibrillation. Analysis and implications |journal=Arch. Intern. Med. |volume=155 |issue=5 |pages=469–73 |year=1995 |month=March |pmid=7864703 |doi= |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=7864703}}</ref>  Despite the fact that there are more very elderly women with atrial fibrillation, when age is adjusted for, the prevalence of atrial fibrillation is higher in men.<ref name="pmid8037127">{{cite journal |author=Furberg CD, Psaty BM, Manolio TA, Gardin JM, Smith VE, Rautaharju PM |title=Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study) |journal=Am. J. Cardiol. |volume=74 |issue=3 |pages=236–41 |year=1994 |month=August |pmid=8037127 |doi= |url=}}</ref><ref name="pmid6869222">{{cite journal |author=Kannel WB, Abbott RD, Savage DD, McNamara PM |title=Coronary heart disease and atrial fibrillation: the Framingham Study |journal=Am. Heart J. |volume=106 |issue=2 |pages=389–96 |year=1983 |month=August |pmid=6869222 |doi= |url=}}</ref>  The rate of rise per year in the risk of atrial fibrillation is slightly higher in the very elderly (1.5% per year for women and 2.0% per year for men over the age of 80 years).  These rates are nearly 15 to 20 times higher than in those under the age of 40.<ref name="pmid9337224">{{cite journal |author=Psaty BM, Manolio TA, Kuller LH, ''et al'' |title=Incidence of and risk factors for atrial fibrillation in older adults |journal=Circulation |volume=96 |issue=7 |pages=2455–61 |year=1997 |month=October |pmid=9337224 |doi= |url=http://circ.ahajournals.org/cgi/pmidlookup?view=long&pmid=9337224}}</ref><ref name="pmid3632164">{{cite journal |author=Wolf PA, Abbott RD, Kannel WB |title=Atrial fibrillation: a major contributor to stroke in the elderly. The Framingham Study |journal=Arch. Intern. Med. |volume=147 |issue=9 |pages=1561–4 |year=1987 |month=September |pmid=3632164 |doi= |url=http://archinte.ama-assn.org/cgi/pmidlookup?view=long&pmid=3632164}}</ref><ref name="pmid7733127">{{cite journal |author=Krahn AD, Manfreda J, Tate RB, Mathewson FA, Cuddy TE |title=The natural history of atrial fibrillation: incidence, risk factors, and prognosis in the Manitoba Follow-Up Study |journal=Am. J. Med. |volume=98 |issue=5 |pages=476–84 |year=1995 |month=May |pmid=7733127 |doi=10.1016/S0002-9343(99)80348-9 |url=}}</ref>
===Incidence===
===Incidence===
Research has shown that the incidence of AF increased from less than 0.1% per year in those under 40 years of age 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 age-adjusted incidence in the [[Framingham Heart Study]] found that in 38 years of follow-up, 20.6% of men and 26.0% of women who had developed AF had [[congestive heart failure]] at inclusion versus 3.2% and 2.9%, respectively, of those without AF. Among patients referred for treatment of [[heart failure]], the 2-to-3-year incidence of AF was 5% to 10%. There was some evidence to suggest that incidence of AF may be lower in heart failure patients with pharmacologic intervention.<ref name="pmid16908781">{{Cite pmid|16908781}}</ref>
Research has shown that the incidence of AF increased from less than 0.1% per year in those under 40 years of age 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 age-adjusted incidence in the [[Framingham Heart Study]] found that in 38 years of follow-up, 20.6% of men and 26.0% of women who had developed AF had [[congestive heart failure]] at inclusion versus 3.2% and 2.9%, respectively, of those without AF. Among patients referred for treatment of [[heart failure]], the 2-to-3-year incidence of AF was 5% to 10%. There was some evidence to suggest that incidence of AF may be lower in heart failure patients with pharmacologic intervention.<ref name="pmid16908781">{{Cite pmid|16908781}}</ref>

Revision as of 20:59, 8 January 2013

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Atrial fibrillation is the most common arrhythmia found in clinical practice.[1] It accounts for 1/3 of hospital admissions for cardiac rhythm disturbances[1], and the rate of admissions for AF has risen in recent years.[2]

Epidemiology and Demographics

Incidence

Research has shown that the incidence of AF increased from less than 0.1% per year in those under 40 years of age 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 age-adjusted incidence in the Framingham Heart Study found that in 38 years of follow-up, 20.6% of men and 26.0% of women who had developed AF had congestive heart failure at inclusion versus 3.2% and 2.9%, respectively, of those without AF. Among patients referred for treatment of heart failure, the 2-to-3-year incidence of AF was 5% to 10%. There was some evidence to suggest that incidence of AF may be lower in heart failure patients with pharmacologic intervention.[1]

Prevalence

It should be noted that the prevalence of atrial fibrillation increases with increasing age, and its prevalence is increased among Caucasians, patients with hypertension and valvular heart disease[3]. The prevalence in the general population is 0.4%.[4]

United States

Approximately 2.2 million individuals in the United States and 4.5 million in the European Union have AF.[1][5]

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.[6]

References

  1. ↑ 1.0 1.1 1.2 1.3 PMID 16908781 (PMID 16908781)
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  2. ↑ Friberg J, Buch P, Scharling H, Gadsbphioll N, Jensen GB. (2003). "Rising rates of hospital admissions for atrial fibrillation". Epidemiology. 14 (6): 666–72. doi:10.1097/01.ede.0000091649.26364.c0. PMID 14569181.
  3. ↑ 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)
  4. ↑ 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)
  5. ↑ 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.
  6. ↑ 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
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