Atrial fibrillation (AF) is a specific kind of irregular heart beat that can be silent or symptomatic and impacts millions of people. We see many patients with AF at the Kahn Center for Cardiac Longevity, some of whom are in AF chronically and some go in and out of it (paroxysmal AF or PAF). It has been unclear how big a risk it was for developing AF over a lifetime, and the consequences of AF.
New data address these uncertainties and the results are powerful.
The population of Denmark from 1 January 2000 to 31 December 2022 was studied, including 3.5 million individuals (51.7% women and 48.3% men) who did not have atrial fibrillation at 45 years of age. They were followed up until incident atrial fibrillation, death, or end of follow-up, whichever came first. All 362 721 individuals with incident atrial fibrillation (46.4% women and 53.6% men), but with no prevalent complication, were further followed up until incident heart failure, stroke, or myocardial infarction.
The lifetime risk of atrial fibrillation increased from 24% in 2000-10 to 31% in 2011-22 .
After atrial fibrillation, the most frequent complication was heart failure with a lifetime risk of 42%.
The lifetime risks of stroke and of myocardial infarction (heart attack) after atrial fibrillation were 20% for stroke 10% for myocardial infarction.
Lifetime risk of atrial fibrillation increased over two decades of follow-up. In individuals with atrial fibrillation, about two in five developed heart failure and one in five had a stroke over their remaining lifetime after atrial fibrillation diagnosis.
Strategies to prevent AF are key such as weight management, alcohol reduction, and blood pressure optiimization, and treatment of sleep apnea.
Early detection using smart watches and home ECG monitors may permit earlier prevention and treatment strategies.
Stroke risks and heart failure prevention strategies are needed for people with atrial fibrillation.
