Hospital Visits for Irregular Heart Beats Rising

Introduction

What is Atrial Fibrillation?

Atrial fibrillation (AF) is an irregular heartbeat that can lead to stroke and other heart-related complications. The most common cardiac arrhythmia, (heart rhythm disorder), may cause no symptoms, but it is often associated with palpitations, fainting, chest pain, or congestive heart failure. In some cases, however, AF is caused by idiopathic or benign conditions. An arrhythmia is a problem with the rate or rhythm of the heartbeat. During an arrhythmia, the heart can beat too fast, too slow, or with an irregular rhythm. AF may be identified clinically when taking a pulse, and its presence can be confirmed with an electrocardiogram (ECG or EKG) that demonstrates the absence of P waves and an irregular ventricular rate.

Main Item

Researchers, analyzing data from almost 4 million hospitalizations for atrial fibrillation in 2001-10, found:

• In-hospital deaths declined, but hospitalizations increased by 23 percent, especially in people over age 65.
• The number of days people were hospitalized didn't change. But after adjusting for inflation, the average cost of hospitalization rose from $6,410 to $8,439 "a 24 percent increase.
• More women were hospitalized, but the difference between men is narrowing.
• Hospitals in the south had the highest percentage of AF hospitalizations (38 percent) while those in the west had the lowest (14 percent).
• High blood pressure was a coexisting condition about 60 percent of the time.
• Diabetes and lung disease were each coexisting conditions about 20 percent of the time.
• Rates of kidney failure as a coexisting condition increased four-fold since 2000 and reached 12.3 percent by 2010.
• In-hospital death rate was highest among those with heart failure (8.2 percent) or older than 80 (about 2 percent).

"Atrial fibrillation is a disease in itself, but it also serves as a marker for the severity of other illnesses," said Nileshkumar Patel, M.D., lead author and internal medicine physician at Staten Island University Hospital, New York.

The hike in hospitalizations is probably because we're living longer and accompanying risk factors such as high blood pressure, obesity, sleep apnea and diabetes are increasing, he said. Generally, the more secondary conditions people had, the longer their hospital stay and the higher their cost.

Researchers analyzed results from the Nationwide Inpatient Sample, the largest in-patient hospital database in the United States. The Agency for Healthcare Research and Quality collected the information from more than 1,200 hospitals across 45 states. The records yielded a cross-section of 3.96 million hospitalizations where atrial fibrillation was the primary diagnosis at discharge.

At least 2.7 million people were living with AF in the United States in 2010, according to the American Heart Association. Seniors over 65 are the fastest growing age group in the United States, which suggests atrial fibrillation will become a major burden on hospitals.

"We must treat atrial fibrillation and its risk factors better in the outpatient setting to prevent hospitalizations and reduce its staggering impact," said Abhishek Deshmukh, M.D., a study author and a cardiologist at the University of Arkansas for Medical Sciences in Little Rock.

Other Co-authors

Sadip Pant, M.D.; Vikas Singh, M.D.; Nilay Patel, M.D.; Shilpkumar Arora, M.D.; Neeraj Shah, M.D.; Ankit Chothani, M.D.; Ghanshyambhai Savani, M.D.; Kathan Mehta, M.D.; Valay Parikh, M.D.; Ankit Rathod, M.D.; Apurva Badheka, M.D.; James Lafferty, M.D.; Marcin Kowalski, M.D.; Jawahar Mehta, M.D.; Raul Mitrani, M.D.; Juan Viles-Gonzalez, M.D.; and Hakan Paydak, M.D. Author disclosures are on the manuscript.

Statements and conclusions of study authors published in American Heart Association scientific journals are solely those of the study authors and do not necessarily reflect the association's policy or position. The association makes no representation or guarantee as to their accuracy or reliability. The association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific association programs and events. The association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at www.heart.org/corporatefunding

Attribution/Source(s):
This quality-reviewed publication was selected for publishing by the editors of Disabled World (DW) due to its significant relevance to the disability community. Originally authored by American Heart Association, and published on 2014/05/24 (Edit Update: 2018/10/24), the content may have been edited for style, clarity, or brevity. For further details or clarifications, American Heart Association can be contacted at Bridgette McNeill - bridgette.mcneill@heart.org - Ph. 214-706-1135. NOTE: Disabled World does not provide any warranties or endorsements related to this article.