Heart failure is the most common complication of atrial fibrillation, finds study

Approximately 33.5 million people worldwide are affected by atrial fibrillation each year.

Atrial fibrillation (AF) can lead to various heart problems due to its irregular and rapid heart rate. It increases the risk of blood clots forming in the atria, which can result in strokes. The irregular rhythm can weaken the heart muscle over time, leading to heart failure and cardiomyopathy.

In the study, Researchers analyzed national data from 3.5 million Danish adults aged 45 or older with no prior history of atrial fibrillation over a 23-year period to determine AF development. They followed 362,721 individuals newly diagnosed with AF, without prior complications, until a diagnosis of heart failure, stroke, or heart attack. Factors like high blood pressure, diabetes, high cholesterol, heart failure, lung and kidney disease were considered.

The results revealed a rise in lifetime atrial fibrillation risk from 24% (2000-2010) to 31% (2011-2022), with men and those with heart issues experiencing larger increases. Heart failure was the most common complication (41% lifetime risk), followed by stroke (21%) and heart attack (12%). Men had higher risks of heart failure (44% vs. 33%) and heart attack (12% vs. 10%) than women, while stroke risk was slightly lower in men (21% vs. 23%). However, there was minimal improvement in heart failure risk and only slight decreases in stroke and heart attack risks over the study period.

“Our novel quantification of the long term downstream consequences of atrial fibrillation highlights the critical need for treatments to further decrease stroke risk as well as for heart failure prevention strategies among patients with atrial fibrillation”

said the study authors.

Reference: Nicklas Vinter, Pia Cordsen, Søren Paaske Johnsen, et al; Temporal trends in lifetime risks of atrial fibrillation and its complications between 2000 and 2022: Danish, nationwide, population based cohort study; The BMJ; https://doi.org/10.1136/bmj-2023-077209