Increasing Trends in Hospitalization for Atrial Fibrillation in the United States, 1985 Through 1999

TLDR

Atrial fibrillation is the most common sustained heart rhythm disturbance, linked to a five‑fold higher stroke risk and an enormous, growing public‑health burden. Hospitalization data were derived from the National Hospital Discharge Survey, estimating annual AF admissions and prevalence among adults aged 35 and older. Between 1985 and 1999, AF hospitalizations more than doubled, prevalence rose with age and was higher in men, comorbidities increased, and discharge patterns shifted toward long‑term care with fewer home discharges, while in‑hospital mortality stayed flat. Primary prevention of atrial fibrillation should be pursued to reduce cardiovascular morbidity and mortality.

Abstract

Atrial fibrillation, the most common sustained disturbance of heart rhythm, is associated with a 5-fold increase in the incidence of ischemic stroke.The National Hospital Discharge Survey was used to estimate the annual number and prevalence of hospitalizations with atrial fibrillation among men and women 35 years of age or older. From 1985 through 1999, hospitalizations increased from 154 086 to 376 487 for a first-listed diagnosis and from 787 750 to 2 283 673 for any diagnosis. Prevalence was higher among successive age groups. Age-standardized prevalence was consistently higher among men than women. In 1999, essential hypertension, ischemic heart disease, congestive heart failure, and diabetes were prominent coexisting conditions. The number of male patients discharged home decreased from 77% to 63%, whereas the number of discharges to long-term care increased from 9% to 15%; the corresponding values for women were 72% to 56% and 15% to 23%. A slight increase in discharges to short-term care was indicated, whereas no trends were noted for in-hospital mortality.Hospitalizations for atrial fibrillation have increased dramatically (2- to 3-fold) in recent years. The public health burden of atrial fibrillation is enormous and expected to continue to increase over the next decades. Primary prevention of atrial fibrillation must be recognized and pursued as a complementary management strategy for reducing cardiovascular morbidity and mortality.