Prevalence and incidence of atrial fibrillation

Atrial fibrillation (AF; Figure 1.1) is the most common cardiac arrhythmia that
clinicians encounter in their daily clinical practice. AF affects 1.01.5% of the
population in the developed world [1,2]
Currently, in the USA, approximately
3 million people have a diagnosis of AF and, based on the census, this number
may rise to 12 million by 2050 [3].
The prevalence and incidence of AF increases sharply with advancing age. The
prevalence of AF rises from 0.7% in the age group 5559 years to 17.8% in those
aged 85 years and over [4]
The overall incidence for AF is 9.9/1000 person-years
[4], and the incidence in the group aged 5559 years is 1.1/1000 person-years,
which rises to 20.7/1000 person-years in the group aged 8084 years and stabilizes
in those aged 85 years and above.
Of note, 70% of AF patients are aged between
65 and 85 years and, overall, 84% are older than 65 years [5].
In the Framingham study, the lifetime risk for the development of AF was
one in four for men and women aged 40 years and older [6].
The data from
Europe showed a similar lifetime risk of developing AF after the age of 55 years:
23.8% in men and 22.2% in women [4].
AF is 1220 times more common in
people aged 8085 years compared with individuals aged 5060 years [4,6].

Mortality, morbidity, and quality of life in atrial fibrillation

AF can cause distressing palpitations and shortness of breath. It can also
precipitate ischemic syndromes and heart failure. Patients with AF have a
threefold increased risk of congestive cardiac failure [7].
Heart failure promotes
AF, which in turn aggravates heart failure. Individuals with either condition
who develop the other condition share a poor prognosis.
AF is also associated with up to twice the rate of total mortality and
cardiovascular death compared with patients in normal sinus rhythm,
and is linked to the severity of underlying heart disease [8,9].
The risk of stroke is increased fivefold with AF [10].
The annual incidence of ischemic stroke is 5% among people with non-valvular AF, two to seven times
that of
people without AF [1].