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Schak L, Petersen JK, Vinding NE, Andersson C, Weeke PE, Kristensen SL, Gundlund A, Schou M, Køber L, Fosbøl EL, Østergaard L. Temporal changes in incidence, treatment strategies and 1-year re-admission rates in patients with atrial fibrillation/flutter under 65 years of age: A Danish nationwide study. Int J Cardiol 2023; 382:23-32. [PMID: 37031708 DOI: 10.1016/j.ijcard.2023.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Revised: 03/22/2023] [Accepted: 04/04/2023] [Indexed: 04/11/2023]
Abstract
AIM To examine temporal changes in incidence rates of atrial fibrillation/flutter (AF), treatment strategies, and AF readmission rates in patients <65 years. METHODS Using Danish nationwide registries, we identified patients <65 years with a first-time AF diagnosis from 2000 to 2018. The cohort was categorized according to calendar periods; 2000-2002, 2003-2006, 2007-2010, 2011-2014, and 2015-2018. In this retrospective cohort study the incidence rate (IR) of AF per 100,000 person years (PY), catheter ablation, electrical cardioversion, use of pharmacotherapy, and AF readmission, were investigated in the first year following AF diagnosis. RESULTS We identified 60,917 patients; 8150 (13.4%) in 2000-2002, 11,898 (19.5%) in 2003-2006, 13,560 (22.3%) in 2007-2010, 14,167 (23.3%) in 2011-2014, and 13,142 (21.6%) in 2015-2018. Apart from 2015 to 2018, a stepwise increase in the crude IR of AF was observed across calendar periods; 2000-2002: 78.7 (95% CI 77.0;80.4), 2003-2006: 86.3 (84.7;87.8), 2007-2010: 97.9 (96.3;99.6), 2011-2014: 102.3 (100.7;104.0), 2015-2018: 93.6 (92.0;95.2). Over the studied time-periods, we found a stepwise increase in the cumulative incidence of catheter ablation (1.2% to 7.6%) electrical cardioversion (2.0% to 8.7%) and treatment with oral anticoagulant therapy (OAC) (28.5% to 47.8%) within the first year of diagnosis. No temporal differences in incidence of 1-year AF readmission were identified (AF-readmissions: 2000-2002: 32.7%, 2003-2006: 31.1%, 2007-2010: 32.2%, 2011-2014: 32.1% and 2015-2018: 31.7%). CONCLUSION The incidence rate of AF in patients <65 years increased from 2000 to 2018, as did the use of catheter ablation, electrical cardioversion and OAC in the first year following AF diagnosis. 1-year AF readmission incidence remained stable around 32% over the study period.
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Affiliation(s)
- Lukas Schak
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark.
| | - Jeppe Kofoed Petersen
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Naja Emborg Vinding
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Charlotte Andersson
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Cardiovascular Division, Brigham and Women's Hospital, Boston, USA
| | - Peter E Weeke
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Søren Lund Kristensen
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Anna Gundlund
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Morten Schou
- Department of Cardiology, Copenhagen University Hospital - Herlev and Gentofte, Herlev, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Lars Køber
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Emil Loldrup Fosbøl
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
| | - Lauge Østergaard
- Department of Cardiology, Centre B, Copenhagen University Hospital - Rigshospitalet, Copenhagen, Denmark
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