Atrial Fibrillation Is Less Deadly Than It Used To Be: Study

A new analysis suggests that atrial fibrillation (AFib), while still a serious heart condition, has seen a decline in fatalities related to AFib over the last several decades.

Published in BMJ, the authors looked at a cohort of the Framingham Heart Study during three periods (1972-85, 1986-2000, and 2001-2015) who had no AFib and identified new AFib (or atrial flutter) during the study periods. The authors calculated hazard ratios for the association between time varying AFib, and also estimated the difference between restricted mean survival times (adjusted) between those with AFib and matched referents at 10 years after diagnosis of AFib. The primary outcome measure was all-cause mortality. The study included 5,671 participants from study period 1, 6,177 from period 2, and 6,174 from period 3.

According to the results, after 10 years following AFib diagnosis, the adjusted difference in survival times between those with AFib and those without decreased by 31% (from -2.9 years in period 1 to -2.1 years in period 2 to -2.0 years in period 3 (P for trend=0.003). Adjusted hazard ratios for all-cause mortality between study participants and those without AFib were 1.9 (95% CI, 1.7 to 2.2) in period 1, 1.4 (95% CI, 1.3 to 1.6) in period 2, and 1.7 (95% CI, 1.3 to 2.0) in period 3 (P for trend=0.70).

The authors cited not having enough information on treatments for AFib (such as anticoagulation or other drug treatments for underlying cardiovascular disease) as one of the chief limitations of the study. Another limitation was the limited length of follow-up.

“We found no evidence of a temporal trend in hazard ratios between newly diagnosed AFib and all cause mortality,” the authors concluded. “The hazard ratios for non-cardiovascular death declined over time but no evidence of a temporal trend for cardiovascular death was found. Mortality associated with newly diagnosed AFib remained high compared with individuals without AFib, despite showing some improvements over the past 45 years. More than 10 years after a diagnosis of atrial fibrillation, individuals with AFib lose about two years of life compared with matched referents.”