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Incidence of AF in the UK

 

Clinical bottom line

The incidence of chronic AF in the UK was estimated to be 1.7 per 1,000 person years. In patients older than 60 years, it was 3 per 1,000 person years. Incidence was higher in older persons.


Reference:

A Ruigómez et al. Incidence of chronic atrial fibrillation in general practice and its treatment pattern. Journal of Clinical Epidemiology 2002 55: 358-363.

Study

This was a retrospective cohort analysis of the UK general practice research database. Identified were 703,000 persons aged 40-89 years enrolled with a GP for more than two years, and with a prescription history of more than one year before January 1996.

This identified 1,714 patients with a first code of AF during 1996. For each a questionnaire was sent to the GP asking them to classify the AF as chronic or paroxysmal, based on definitions of each provided. Chronic AF was persistence of the arrhythmia, with AF not converting to sinus rhythm within one week. 1,606 valid replies were received, giving 1,035 incident cases of chronic AF.

A random selection of the source population was used as controls (5,000). Demography and other information was gathered on cases and controls.

Results

The overall incidence was 1.7 per 1,000 person years. This rose with age (Figure 1) and in persons older than 60 years the incidence was 3 per 1,000 person years. Incidence was higher in men than women (relative risk 1.4).

Figure 1: Incidence of AF by age and sex


Other factors that carries an increased risk of AF were BMI above 30, alcohol consumption above 42 units a week, chronic respiratory disease, hyperthyroidism, and any cardiac morbidity.

Comment

This is a useful paper that will tell primary care organisations the likely number of new cases of AF to expect in any year. There is also useful information on treatment, but that may be only of historical interest, since large changes may be expected since 1996 as UK primary care has undergone several changes.