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Observational Study
. 2018 Jul;11(7):e006273.
doi: 10.1161/CIRCEP.118.006273.

Frequency of Cardiac Rhythm Abnormalities in a Half Million Adults

Shaan Khurshid  1 , Seung Hoan Choi  2 , Lu-Chen Weng  2 , Elizabeth Y Wang  2 , Ludovic Trinquart  3   4 , Emelia J Benjamin  4   5   6 , Patrick T Ellinor  2   7 , Steven A Lubitz  8   7
Affiliations
Observational Study

Frequency of Cardiac Rhythm Abnormalities in a Half Million Adults

Shaan Khurshid et al. Circ Arrhythm Electrophysiol. 2018 Jul.

Abstract

Background: The frequency of cardiac rhythm abnormalities and their risk factors in community-dwelling adults are not well characterized.

Methods: We determined the frequency of rhythm abnormalities in the UK Biobank, a national prospective cohort. We tested associations between risk factors and incident rhythm abnormalities using multivariable proportional hazards regression.

Results: Of 502 627 adults (median age, 58 years [interquartile range, 13]; 54.4% women), 2.35% had a baseline rhythm abnormality. The prevalence increased with age with 4.84% of individuals aged 65 to 73 years affected. During 3 368 332 person-years of follow-up, 15 906 new rhythm abnormalities were detected (4.72 per 1000 person-years; 95% confidence interval [CI]: 4.65-4.80). Atrial fibrillation (3.11 per 1000 person-years; 95% CI: 3.05-3.17), bradyarrhythmias (0.89 per 1000 person-years; 95% CI: 0.86-0.92), and conduction system diseases (1.06 per 1000 person-years; 95% CI: 1.02-1.09) were more common than supraventricular (0.51 per 1000 person-years; 95% CI: 0.48-0.53) and ventricular arrhythmias (0.57 per 1000 person-years; 95% CI: 0.55-0.60). Older age (hazard ratio [HR]: 2.35 per 10-year increase; 95% CI: 2.29-2.41; P<0.01), male sex (HR: 1.83; 95% CI: 1.76-1.89; P<0.01), hypertension (HR: 1.49; 95% CI: 1.44-1.54; P<0.01), chronic kidney disease (HR: 1.95; 95% CI: 1.67-2.27; P<0.01), and heart failure (HR: 1.99; 95% CI: 1.76-2.26; P<0.01) were associated with new rhythm abnormalities.

Conclusions: The frequency of rhythm abnormalities in middle-aged to older community-dwelling adults is substantial. Atrial fibrillation, bradyarrhythmias, and conduction system diseases account for most rhythm conditions.

Keywords: atrial fibrillation; bradycardia; heart failure; tachycardia, supraventricular; tachycardia, ventricular.

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Figures

Figure 1
Figure 1. Frequency of cardiac rhythm abnormalities stratified by age and sex
Plot depicting a) age- and sex-stratified baseline prevalence, and b) age- and sex-stratified incidence rates of rhythm abnormalities during the study period. The minimum age in the age < 55 years stratum was 37 years, and the maximum age in the ≥ 65 years stratum was 73 years.
Figure 2
Figure 2. Multivariable associations among clinical risk factors and incident rhythm abnormalities
Plot depicting multivariable associations between baseline clinical factors and incident rhythm abnormalities. Green shades indicate hazard ratios < 1 while red shades indicate hazard ratios ≥ 1. Intensity of shade is proportional to the magnitude of effect. Grayed cells indicate non-significant associations. Due to exclusion of participants with missing data, or prevalent rhythm conditions from incident analyses, the number of participants included in each model varied (485,129 for any arrhythmia, 489,194 for atrial fibrillation, 494,652 for bradyarrhythmias, 495,356 for conduction system disease, 494,796 for supraventricular arrhythmias, and 495,620 for ventricular arrhythmias)
See this image and copyright information in PMC

References

    1. Benjamin EJ, Blaha MJ, Chiuve SE, Cushman M, Das SR, Deo R, de Ferranti SD, Floyd J, Fornage M, Gillespie C, Isasi CR, Jiménez MC, Jordan LC, Judd SE, Lackland D, Lichtman JH, Lisabeth L, Liu S, Longenecker CT, Mackey RH, Matsushita K, Mozaffarian D, Mussolino ME, Nasir K, Neumar RW, Palaniappan L, Pandey DK, Thiagarajan RR, Reeves MJ, Ritchey M, Rodriguez CJ, Roth GA, Rosamond WD, Sasson C, Towfighi A, Tsao CW, Turner MB, Virani SS, Voeks JH, Willey JZ, Wilkins JT, Wu JH, Alger HM, Wong SS, Muntner P Subcommittee AHASCaSS. Heart Disease and Stroke Statistics-2017 Update: A Report From the American Heart Association. Circulation. 2017;135:e146–e603. - PMC - PubMed
    1. Go AS, Hylek EM, Phillips KA, Chang Y, Henault LE, Selby JV, Singer DE. 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. 2001;285:2370–5. - PubMed
    1. 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, Investigators A. Relationships between sinus rhythm, treatment, and survival in the atrial fibrillation follow-up investigation of rhythm management (AFFIRM) study. Circulation. 2004;109:1509–1513. - PubMed
    1. Stewart S, Hart CL, Hole DJ, McMurray JJV. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med. 2002;113:359–364. - PubMed
    1. Wolf PA, Abbott RD, Kannel WB. Atrial-fibrillation - A major contributor to stroke in the elderly - The Framingham Study. Arch Intern Med. 1987;147:1561–1564. - PubMed

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