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Roy Salmon Patient, A-Fib Free; pacemakerclub.com, Sept. 2013

A-Fib Hospitalizations Up Sharply since 2000

A-Fib admissions up 23%

Research Findings

A-Fib Hospitalizations Up Sharply since 2000

US researchers found a 23% jump in overall hospitalizations due to A-Fib in the decade 2000 to 2010, and the costs of treating A-Fib rose 24%.

But the number of A-Fib patients dying in hospital decreased. There was a 29.2% drop in the mortality rate, which fell from 1.2% to 0.9%.

The study’s data was obtained from the ‘Nationwide Impatient Sample’ of 3.9 million medical records. The study author was Dr. Nileshkumar Patel at Staten Island University Hospital in New Your City.

Some of this increase in hospitalizations was due to the increase in US population (particularly older Americans). Older patients drove most of the total hospitalization increase.

Among people over the age of 80, the annual A-Fib hospitalization rate jumped from 9,361 to 11,045 million per year. Hospitals in the South had the highest percentage of A-Fib admissions (38%), while those in the West had the lowest (14%).

But part of the decade’s 23% increase is due to A-Fib co-morbidities (simultaneous presence of two chronic diseases or conditions). Patients with A-Fib often have other illnesses, too. The most common co-morbidities were hypertension, which was observed in 60%, diabetes (21.5%), and chronic pulmonary disease (20%).

Editor’s Comments:
This is not surprising news, but it is somewhat alarming. One of the reasons for the hospitalization increase is both doctors and patients are more aware of A-Fib and the health risks than they were in previous decades. (In 2009, the US Congress declared September as Atrial Fibrillation Awareness month.)
The good news is that fewer A-Fib patients are dying in hospitals probably due to better training and treatment options. But hospitalizations are expected to rise as the US population over age 80 increases from an estimated 11.4 million in 2008 to 19.5 million in 2030. It’s projected 1 out of 10 people over 80 will develop A-Fib. That’s nearly 2 million new patients with A-Fib!
The authors of this study point out that this “will lead to an enormous increased burden on the public health system and associated cost of care.” There will certainly be a lot more hospitalizations for A-Fib.
No Mention of Catheter Ablation: The authors discussed interventions for controlling costs such as the drug therapies of rate control vs. rhythm control. but did not mention catheter ablation (or Maze surgeries).
But the best and most cost-effective way to keep A-Fib patients out of the hospital is to make them A-Fib free, and also to take care of health conditions such as hypertension, obesity, diabetes, sleep apnea, smoking, and binge drinking. (Many EPs today recognize the importance of these health problems and how much they contribute to A-Fib. They require their patients to deal with these health problems before they can get a catheter ablation.)
From a public health perspective, shouldn’t we as citizens focus our efforts on strategies and treatments that offer the hope of a cure for A-Fib? That’s the best way to keep people out of hospitals.
References for this Article

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Last updated: Sunday, February 15, 2015

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