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The burden of atrial fibrillation

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Clinical Research in Cardiology Supplements Aims and scope

Abstract

Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia observed in clinical practice. It is characterized by chaotic electrical activity in the atria with consequent loss of atrial mechanical function and irregular induction of ventricular contraction. AF adversely affects quality of life and causes considerable mortality and morbidity, particularly from heart failure, stroke, and brady- or tachyarrhythmia. Its incidence and prevalence increases in the aging population, rising from 0.1% in subjects under 55 years up to 9% among patients older than 80 years. Consequently, the public health burden associated with AF is increasing, reflecting the aging population. Present studies have shown atrial fibrillation as a powerful contributor to increased mortality and medical cost. Despite improvement in our understanding of the advantages and inconveniencies of rate and rhythm control strategies, current therapeutic options, like anticoagulant and antiarrhythmic therapy, only prevent a part of this burden. This article provides a brief overview of the patients and physicians, such as epidemiologic and socioeconomic burden.

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References

  1. ACTIVE Investigators, Connolly SJ, Pogue J, Hart RG, Hohnloser SH, Pfeffer M, Chrolavicius S, Yusuf S (2009) Effect of clopidogrel added to aspirin in patients with atrial fibrillation. N Engl J Med 360:2066–2078

    Article  PubMed  Google Scholar 

  2. Andersen LV, Vestergaard P, Deichgraeber P, Lindholt JS, Mortensen LS, Frost L (2008) Warfarin for the prevention of systemic embolism in patients with non-valvular atrial fibrillation: a meta-analysis. Heart 94:1607–1613

    Article  PubMed  CAS  Google Scholar 

  3. Baine WB, Yu W, Weis KA (2001) Trends and outcomes in the hospitalization of older Americans for cardiac conduction disorders or arrhythmias, 1991–1998. J Am Geriatr Soc 49:763–770

    Article  PubMed  CAS  Google Scholar 

  4. Brand FN, Abbott RD, Kannel WB, Wolf PA (1985) Characteristics and prognosis of lone atrial fibrillation. JAMA 54:3449–3453

    Article  Google Scholar 

  5. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D (1998) Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation 98:946–952

    PubMed  CAS  Google Scholar 

  6. Caro JJ (2004) An economic model of stroke in atrial fibrillation: the cost of suboptimal oral anticoagulation. Am J Manag Care 10:451–458

    Google Scholar 

  7. Corley SD, Epstein AE, DiMarco JP, Domanski MJ, Geller N, Greene HL, Josephson RA, Kellen JC, Klein RC, Krahn AD, Mickel M, Mitchell LB, Nelson JD, Rosenberg Y, Schron E, Shemanski L, Waldo AL, Wyse DG, AFFIRM Investigators (2004) Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation 109:1509–1513

    Article  PubMed  Google Scholar 

  8. 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 155:469–473

    Article  PubMed  CAS  Google Scholar 

  9. Fetsch T, Bauer P, Engberding R, Koch HP, Lukl J, Meinertz T, Oeff M, Seipel L, Trappe HJ, Treese N, Breithardt G (2004) Prevention of Atrial Fibrillation after Cardioversion Investigators. Prevention of atrial fibrillation after cardioversion: results of the PAFAC trial. Eur Heart J 25:1385–1394

    Article  PubMed  Google Scholar 

  10. Fuster V, Ryden LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA, Halperin JL, Le Heuzey JY, Kay GN, Lowe JE, Olsson SB, Prystowsky EN, Tamargo JL, Wann S (2006) ACC/AHA/ESC 2006 guidelines for the management of patients with atrial fibrillation-executive summary: 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 (Writing Committee to Revise the 2001 Guidelines for the Management of Patients with Atrial Fibrillation). Eur Heart J 27:1979–2030 (Task Force on Practice Guidelines, American College of Cardiology/American Heart Association; Committee for Practice Guidelines, European Society of Cardiology; European Heart Rhythm Association; Heart Rhythm Society)

    Article  PubMed  Google Scholar 

  11. Gage BF, van Walraven C, Pearce L, Hart RG, Koudstaal PJ, Boode BSP, Petersen P (2004) Selecting patients with atrial fibrillation for anticoagulation stroke risk stratification in patients taking aspirin. Circulation 110:2287–2292

    Article  PubMed  CAS  Google Scholar 

  12. 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 285:2370–2375

    Article  PubMed  CAS  Google Scholar 

  13. Hart RG (2003) Atrial fibrillation and stroke prevention. N Engl J Med 349:1015–1016

    Article  PubMed  CAS  Google Scholar 

  14. Haïssaguerre M, Jaïs P, Shah DC, Takahashi A, Hocini M, Quiniou G, Garrigue S, Le Mouroux A, Le Métayer P, Clémenty J (1998) Spontaneous initiation of atrial fibrillation by ectopic beats originating in the pulmonary veins. N Engl J Med 339:659–666

    Article  Google Scholar 

  15. Hohnloser SH, Crijns HJ, van Eickels M, Gaudin C, Page RL, Torp-Pedersen C, Connolly SJ, ATHENA Investigators (2009) Effect of dronedarone on cardiovascular events in atrial fibrillation. N Engl J Med 360:668–678

    Article  PubMed  CAS  Google Scholar 

  16. Hughes M, Lip GY (2007) Risk factors for anticoagulation-related bleeding complications in patients with atrial fibrillation: a systematic review. QJM 100:599–607 (on behalf of the Guideline Development Group for the NICE national clinical guideline for management of atrial fibrillation in primary and secondary care)

    Article  PubMed  CAS  Google Scholar 

  17. Hylek EM, Skates SJ, Sheehan MA, Singer DE (1996) An analysis of the lowest effective intensity of prophylactic anticoagulation for patients with nonrheumatic atrial fibrillation. N Engl J Med 335:540–546

    Article  PubMed  CAS  Google Scholar 

  18. Lévy S, Maarek M, Coumel P, Guize L, Lekieffre J, Medvedowsky JL, Sebaoun A (1999) Characterization of different subsets of atrial fibrillation in general practice in France: the ALFA study. The College of French Cardiologists. Circulation 99:3028–3035

    PubMed  Google Scholar 

  19. Kerr CR, Humphries KH, Talajic M, Klein GJ, Connolly SJ, Green M, Boone J, Sheldon R, Dorian P, Newman D (2005) Progression to chronic atrial fibrillation after the initial diagnosis of paroxysmal atrial fibrillation: results from the Canadian Registry of Atrial Fibrillation. Heart J 149:489–496

    Article  Google Scholar 

  20. Køber L, Torp-Pedersen C, McMurray JJ, Gøtzsche O, Lévy S, Crijns H, Amlie J, Carlsen J, Dronedarone Study Group (2008) Increased mortality after dronedarone therapy for severe heart failure. N Engl J Med 358:2678–2687

    Article  PubMed  Google Scholar 

  21. Reynolds MR, Essebag V, Zimetbaum P, Cohen DJ (2007) Healthcare resource utilization and costs associated with recurrent episodes of atrial fibrillation: the FRACTAL registry. J Cardiovasc Electrophysiol 18:628–633

    Article  PubMed  Google Scholar 

  22. Ryder KM, Benjamin EJ (1999) Epidemiology and significance of atrial fibrillation. Am J Cardiol 84:131R–138R

    Article  PubMed  CAS  Google Scholar 

  23. Singh BN, Singh SN, Reda DJ, Tang XC, Lopez B, Harris CL, Fletcher RD, Sharma SC, Atwood JE, Jacobson AK, Lewis HD Jr, Raisch DW, Ezekowitz MD, Sotalol Amiodarone Atrial Fibrillation Efficacy Trial (SAFE-T) Investigators (2005) Amiodarone versus sotalol for atrial fibrillation. N Engl J Med 352:1861–1872

    Article  PubMed  CAS  Google Scholar 

  24. SPAF II Investigators (1994) Warfarin versus aspirin for prevention of thromboembolism in atrial fibrillation: Stroke Prevention in Atrial Fibrillation II Study. Lancet 343:687–691

    Article  Google Scholar 

  25. Teo KK, Yusuf S, Furberg CD (1993) Effects of prophylactic antiarrhythmic drug therapy in acute myocardial infarction. An overview of results from randomized controlled trials. JAMA 270:1589–1595

    Article  PubMed  CAS  Google Scholar 

  26. Wattigney WA, Mensah GA, Croft JB (2003) Increasing trends in hospitalization for atrial fibrillation in the United States, 1985 through 1999: implications for primary prevention. Circulation 108:711–716

    Article  PubMed  Google Scholar 

  27. Wolf PA, Mitchell JB, Baker CS, Kannel WB, D'Agostino RB (1998) Impact of atrial fibrillation on mortality, stroke, and medical costs. Arch Intern Med 158:229–234

    Article  PubMed  CAS  Google Scholar 

  28. Zado E, Callans DJ, Riley M, Hutchinson M, Garcia F, Bala R, Lin D, Cooper J, Verdino R, Russo AM, Dixit S, Gerstenfeld E, Marchlinski FE (2008) Long-term clinical efficacy and risk of catheter ablation for atrial fibrillation in the elderly. J Cardiovasc Electrophysiol 19:621–626

    Article  PubMed  Google Scholar 

  29. Zimetbaum P (2007) Amiodarone for atrial fibrillation. N Engl J Med 356:935–941

    Article  PubMed  CAS  Google Scholar 

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Authors and Affiliations

  1. Klinik für Innere Medizin III, Campus Kiel, Universitätsklinikum Schleswig-Holstein, Schittenhelmstr. 12, 24105, Kiel, Germany

    Britta Weidtmann, Thomas Demming & Hendrik Bonnemeier

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  1. Britta Weidtmann
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  2. Thomas Demming
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  3. Hendrik Bonnemeier
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Correspondence to Hendrik Bonnemeier.

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Weidtmann, B., Demming, T. & Bonnemeier, H. The burden of atrial fibrillation. Clin Res Cardiol Suppl 5 (Suppl 1), 57–62 (2010). https://doi.org/10.1007/s11789-010-0002-2

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  • DOI: https://doi.org/10.1007/s11789-010-0002-2

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