Atrial fibrillation (AF) is the most common type of arrhythmia, and treatment of AF represents a significant health care burden for the estimated 2.66 million people who have it. In 2005, the estimated cost of AF was $6.65 billion per year, which included the costs of hospitalization, in- and outpatient physician care, and medications. The incidence of AF is known to increase with age, so as the US population ages, can we expect the incidence and prevalence of AF to continue to rise?

To help answer this question, Susan Colilla, PhD, MPH, and colleagues from Global Health Economics and Outcomes Research in Princeton, New Jersey, reviewed a large health insurance claims database for the years 2001–2008. The database represented a geographically diverse 5% of the US population; the investigators used a progression model that included all diagnosed AF cases as well as those cases expected to be chronic in nature.

Colilla et al. looked about 20 years into the future to 2030. By that time, they expect that AF incidence will double—from 1.2 million cases in 2010 to 2.6 million cases 20 years later. Prevalence, then, is projected to increase from 5.2 million cases in 2010 to 12.1 million cases in 2030. This represents an annual growth rate of 4.3% for prevalence and 4.6% for incidence.

"Variability in future trends in AF incidence and recurrence rates has the greatest impact on the projected estimates of chronic AF prevalence," the authors wrote in the article published in the American Journal of Cardiology. However, "it can be concluded that both incidence and prevalence of AF are likely to rise from 2010 to 2030, but there exists a wide range of uncertainty around the magnitude of future trends."

As AF becomes more common, the public health burden of AF may reach concerning levels by 2030, the authors noted, and more research is needed to investigate what factors may be contributing to this increasing trend—followed by means to mitigate them.

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Colilla S, Crow A, Petkun W, et al. Am J Cardiol. 2013 July 4. [Epub ahead of print]

Keywords: Outpatients, Insurance, Health, Hospitalization

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