Hospitalisation patterns change over time in patients with atrial fibrillation

INTRODUCTION: Atrial fibrillation (AF) is a cardiac epidemic. In this study, we aimed to describe the causes of hospital-isation in an AF population over time and to study how different AF treatment strategies affected hospitalization.

MATERIAL AND METHODS: This was an observational study in which long-term follow-up data were collected from hospital records, discharge papers and diagnostic codes. The study population (n = 156) was observed over a total period of ten years which was divided into two successive observation periods (OP), OP1 and OP2. Fourteen endpoints of cardiovascular hospitalisations were evaluated.

RESULTS: The causes of hospitalisation shifted over time. We observed a lower proportion of admissions due to AF in OP2 (63%) than in OP1 (87%) and a higher proportion of admissions due to congestive heart failure (16% versus 3%) and of days of inpatient care due to ischaemic stroke (25% versus 7%). Persistent AF where sinus rhythm was pursued was associated with a four-fold increase in the risk of hospitalisation (multivariate Poisson analysis, rate ratio 3.97, 95% confidence interval 2.73-5.76, p < 0.0001) compared with accepted permanent AF.

CONCLUSION: Over time, the causes of hospitalisation in an AF population shifted from AF relapse to the most frequent complications of AF, ischaemic stroke and congestive heart failure. In this observational study, patients treated with rhythm control were more frequently hospitalised than patients treated with rate control.

FUNDING: not relevant.

TRIAL REGISTRATION: not relevant.