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Look For Increasing Numbers of Atrial Fibrillation Patients in ED

KALAMAZOO, MI – Patients with atrial fibrillation (AF) are showing up in emergency departments in increasing numbers and the trend is likely to accelerate in coming decades, according to recent research.

A presentation at the recent American Heart Association's Scientific Sessions 2014 discussed the major healthcare burden caused by AF treatment in the ED. The study, led by researchers from the Western Michigan University School of Medicine, analyzed national data on patients presenting to the ED with AF listed as the first diagnosis from 2006-11.

Results indicate the rate of visits increased 24%, from 133 per 100,000 in 2006 to 165 per 100,000 in 2011.

Largely related to the aging of the population in the United States, those increases are likely to continue. A study last year predicted that AF incidence will double from 1.2 million cases in 2010 to 2.6 million cases in 2030. AF prevalence should increase, according to the American Journal of Cardiology report, from 5.2 million in 2010 to 12.1 million cases in 2030.

With an average AF hospital admission rate of 65%, according to the presentation, more than 2.7 million patients were too sick to be sent home. Blood clots, stroke, heart failure and other heart-related complications can result from common arrhythmia.

For those patients admitted, however, in-hospital death rates decreased from 1.18% in 2006 to 0.97% in 2011.

Patients requiring admission for AF tended to be elderly and female, have Medicare or Medicaid, live in areas with low median incomes, and present to teaching hospitals and those in the Northeast and metropolitan areas.

“This study reveals increasing burden of atrial fibrillation on US hospitals with 24% increase in ED visits from 2006-2011,” the authors note. “The decreasing in-hospital mortality rate points to improving care of hospitalized patients. Though the admission rates from ED visits have stayed fairly constant, the absolute numbers have increased.”

"The huge demographic and geographic variations highlight the unmet need for interventions to decrease hospitalization rates," added lead researcher Sourabh Aggarwal, MD.