Rising AF burden surpasses other cardiovascular conditions


By Michael Woodhead

4 Apr 2019

The relentless rise of atrial fibrillation has led to it overtaking myocardial infarction and heart failure in terms of hospitalisation burden, research from the South Australian Health and Medical Research Institute (SAHMRI) shows.

A study of cardiovascular admissions to all Australian hospitals across a 21-year period from 1993 to 2013 showed a relative increase of 295% for patients presenting to hospital with AF – an almost doubling of AF hospitalisations since the beginning of the century.

Presentations for myocardial infarction and heart failure increased by 73% and 39% respectively in the same period. After adjusting for population increases, the annual rate of increase was 5.5% cent for AF, 2.2% cent for myocardial infarction and a negligible change for heart failure.

The research, published in Heart, was led by research student Celine Gallagher from the Institute’s Centre for Heart Rhythm Disorders.

The PhD candidate said the growing number of hospitalisations was seen across all age groups, demonstrating it’s not just related to Australia’s ageing population.

“Furthermore, the costs associated with AF hospitalisations have grown 479% over the 16-year period leading up to 2014, compared to a 210% increase for hospitalisations due to heart attack and heart failure” she said.

The growing trend in hospitalisations due to AF was likely to be multifactorial and fuelled by modifiable factors such as hypertension, coronary artery disease, obesity and diabetes – as well as non cardiac conditions such as COPD, the study authors said.

“Our research also took into account common procedures used to treat AF such as AF ablation.

“While there’s been a significant increase in the use of this procedure since the beginning of this decade, it doesn’t account for the rise in hospitalisations observed in this study”.

There was also a trend for AF patients to have frequent presentations and re-admissions.

Better outpatient management could significantly reduce the number of AF patients returning to hospital because of the condition, said Ms Gallagher, and could also reduce the number of hospitalisations due to other complications associated with AF including stroke and heart failure.

“AF poses a significant and growing healthcare resource burden. New models of care delivery are urgently warranted to stem this rising tide,” the researchers concluded.

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