Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2012 Jan;5(1):85-93.
doi: 10.1161/CIRCOUTCOMES.111.962688. Epub 2012 Jan 10.

Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007

Jonathan P Piccini  1 , Bradley G Hammill, Moritz F Sinner, Paul N Jensen, Adrian F Hernandez, Susan R Heckbert, Emelia J Benjamin, Lesley H Curtis
Affiliations

Incidence and prevalence of atrial fibrillation and associated mortality among Medicare beneficiaries, 1993-2007

Jonathan P Piccini et al. Circ Cardiovasc Qual Outcomes. 2012 Jan.

Abstract

Background: Atrial fibrillation (AF) is a common and costly problem among older persons. The frequency of AF increases with age, but representative national data about incidence and prevalence are limited. We examined the annual incidence, prevalence, and mortality associated with AF among older persons.

Methods and results: In a retrospective cohort study of Medicare beneficiaries 65 years and older diagnosed with AF between 1993 and 2007, we measured annual age- and sex-adjusted incidence and prevalence of AF and mortality following an AF diagnosis. Among 433,123 patients with incident AF, the mean age was 80 years, 55% were women, and 92% were white. The incidence of AF remained steady during the 14-year study period, ranging from 27.3 to 28.3 per 1000 person-years. Incidence rates were consistently higher among men and white beneficiaries. The prevalence of AF increased across the study period (mean, 5% per year) and was robust to sensitivity analyses. Among beneficiaries with incident AF in 2007, 36% had heart failure, 84% had hypertension, 30% had cerebrovascular disease, and 8% had dementia. Mortality after AF diagnosis declined slightly over time but remained high. In 2007, the age- and sex-adjusted mortality rates were 11% at 30 days and 25% at 1 year.

Conclusions: Among older Medicare beneficiaries, incident AF is common and has remained relatively stable for more than a decade. Incident AF is associated with significant comorbidity and mortality; death occurs in one-quarter of beneficiaries within 1 year.

PubMed Disclaimer

Figures

Figure 1
Figure 1. Incidence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 1
Figure 1. Incidence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 1
Figure 1. Incidence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 1
Figure 1. Incidence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 2
Figure 2. Prevalence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 2
Figure 2. Prevalence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 2
Figure 2. Prevalence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 2
Figure 2. Prevalence of Atrial Fibrillation Among Medicare Beneficiaries, 1993-2007
Figure 3
Figure 3. One-Year Mortality Rate After Incident Atrial Fibrillation in 2007
See this image and copyright information in PMC

References

    1. Dorian P, Jung W, Newman D, Paquette M, Wood K, Ayers GM, Camm J, Akhtar M, Luderitz B. The impairment of health-related quality of life in patients with intermittent atrial fibrillation: implications for the assessment of investigational therapy. J Am Coll Cardiol. 2000;36:1303–1309. - PubMed
    1. Kilander L, Andren B, Nyman H, Lind L, Boberg M, Lithell H. Atrial fibrillation is an independent determinant of low cognitive function: a cross-sectional study in elderly men. Stroke. 1998;29:1816–1820. - PubMed
    1. Wang TJ, Larson MG, Levy D, Benjamin EJ, Kupka MJ, Manning WJ, Clouse ME, D'Agostino RB, Wilson PW, O'Donnell CJ. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107:2920–2925. - PubMed
    1. European Heart Rhythm Association; Heart Rhythm Society; Fuster V, Rydén 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, Smith SC, Jr, Jacobs AK, Adams CD, Anderson JL, Antman EM, Hunt SA, Nishimura R, Ornato JP, Page RL, Riegel B, Priori SG, Blanc JJ, Budaj A, Camm AJ, Dean V, Deckers JW, Despres C, Dickstein K, Lekakis J, McGregor K, Metra M, Morais J, Osterspey A, Zamorano JL American College of Cardiology; American Heart Association Task Force on Practice Guidelines; European Society of Cardiology Committee for Practice Guidelines; Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation. 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) J Am Coll Cardiol. 2006;48:854–906. - PubMed
    1. Benjamin EJ, Wolf PA, D'Agostino RB, Silbershatz H, Kannel WB, Levy D. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98:946–952. - PubMed

Publication types