With National Heart Week just around the corner, new research from the University of Queensland has revealed that nearly half of patients admitted to hospital for atrial fibrillation in Australia die within a decade.
A team led by Dr Linh Ngo from UQ’s Faculty of Medicine analysed data from more than 250,000 patients admitted for AF and atrial flutter – a closely related condition – to all public and most private hospitals in Australia and New Zealand between 2008 and 2017.
“AF is the most common heart rhythm disorder and the leading cause of heart-related hospitalisations globally, causing symptoms like palpitations, dizziness, and chest pain,” Dr Ngo said.
“Often occurring with symptomatic episodes of tachyarrhythmia, these hospitalizations are also costly, representing 50%–67% of AF-related health care expenditure.
“The disorder is also closely associated with stroke, but we know much less about the risk of recurrent hospitalisations and other consequences such as heart failure or death. Unfortunately, we found only 55.2% of patients hospitalised with AF survived beyond a decade.”
Dr Ngo said while some of those deaths were attributable to co-existing conditions, the research showed AF reduced a patient’s life expectancy on average by 2.6 years — or nearly one-fifth of their anticipated life expectancy.
“AF-associated cardiovascular outcomes were relatively common, and so was re-hospitalisation for AF or flutter. At 10 years, one in 10 patients had suffered a stroke, one in six were hospitalised for heart failure, and 41.2% had been readmitted due to recurrent AF,” she said.
“We specifically examined the long-term incidence of all-cause mortality and quantified the loss in life expectancy attributable to AF and flutter comparing with the general population.
In proportional term, the highest loss of life expectancy (21.4%) was seen in those aged ≥80 years with the lowest (4.9%) seen in those aged 18–34 years. The years of life lost (2.7 years vs. 2.5 years) and proportion of life lost (16.4% vs. 17.2%) were comparable in males and females.
Co-author and cardiologist, Associate Professor Isuru Ranasinghe from Prince Charles Hospital, said the research revealed at 10 years, less than 7% of patients had catheter ablation procedure, one of the most effective treatments for patients with symptomatic AF.
“It may mean this procedure was underused in Australian and New Zealand hospitals,” Dr Ranasinghe said.
“Clinicians currently primarily focus on preventing the risk of stroke, but these findings emphasise the need to consider atrial fibrillation as a chronic disease with multiple serious downstream consequences.”
“There needs to be a greater focus on preventing recurrent hospitalisations and heart failure, the literature also suggests many patients at high risk of a stroke fail to receive blood thinning medications, so current preventative efforts are far from ideal.
“Better patient education in areas such as blood pressure control and weight loss, as well as appropriate preventative therapy in hospital and primary care could improve the outcomes for people with AF.”