Abstract

Introduction: Atrial fibrillation (AF) and flutter (AFL) are the most common sustained arrhythmia in clinical practice. There is limited data on recent age and sex-specific incidence rates. Aim: This study aimed to analyze incidence rates of AF and AFL in the US, focusing on age and gender-specific trends using the Global Burden of Disease (GBD) 2019 database. Methods: Incidence data was obtained from the GBD 2019 database. Age-adjusted incidence rates were stratified by gender into males and females. Age-specific trends were assessed in two age sub-groups: younger adults (≤55 years) and older adults (>55 years). Time-trends, reported as annual percentage change (APC) and average APC (AAPC), were estimated using Joinpoint Regression Software (v.4.9.0.1, NCI) utilizing Monte Carlo permutation analysis. Results: 607,599 patients were diagnosed with AF and AFL in the US in 2019. Overall, AF and AFL incidence rates have increased in older adults and but remained stable in younger adults (AAPC= 2.2 vs. 0.9; AAPC difference= 1.3, P<0.001). Age-specific trends were neither identical (P<0.001) nor parallel (P<0.001) suggesting that incidence rates are different and increasing at a greater rate in older adults compared to younger adults. However, for both men and women incidence rates have increased over the past two decades at the same rate (AAPC= 2.3 vs. 2.2: AAPC difference= 0.1, P=0.67). Conclusions: Our study showed that AF and AFL incidence increased over the past two decades. This increase is primarily driven by older adults. Further research is warranted to understand the factors contributing to this increase, especially in older adults.

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