Atrial fibrillation (Afib) is a common type of arrhythmia that is becoming more prevalent in people under 65. New research suggests that it is more dangerous in this younger population than previously believed. The study, published today in Circulation Arrhythmia and Electrophysiology and conducted by physician-scientists at the UPMC Heart and Vascular Institute, brings attention to this concerning trend.The research, one of the first of its kind to focus on a large group of Afib patients under the age of 65 in the United States, discovered that these younger patients had a higher likelihood of being hospitalized for heart failure, stroke, or heart attack. They also had significantly higher rates of other health conditions and mortality compared to people of similar age and gender who do not have Afib.
“It’s widely believed among cardiologists that Afib is rare and not harmful in people under 65. But there hasn’t been any data to support that belief,” explained Dr. Aditya Bhonsale, M.D., M.H.S, the lead author of the study and a cardiac electrophysiologist at UPMC’s Division of Cardio.The University of Pittsburgh’s Dr. Bhonsale, who is also an assistant professor of medicine, explained, “At UPMC, we’ve been seeing an increased number of young patients with Afib in recent years and have been interested in understanding the real-world clinical course of these individuals. As a payer-provider with patient records across more than 40 hospitals, UPMC was uniquely positioned to ask this question, which no one has been able to ask before.”
By analyzing the electronic health records of 67,221 UPMC patients seeking care for Afib from 2010 through 2019, the researchers found that over a quarter of them (17,335) were under the age. The prevalence of atrial fibrillation (Afib) in adults under the age of 65 is much higher than the commonly estimated 2%. This high proportion is likely due to an increasing burden of cardiovascular risk factors in younger Americans, according to Bhonsale. The UPMC team discovered that the survival rates for those with Afib over a decade were 1.3 to 1.5 times worse for men and 1.82 to 3.16 times worse for women compared to similarly aged patients without Afib. The patients studied also had high rates of cardiovascular disease risk factors such as smoking, obesity, hypertension, and sleep apnea, which contribute to damaging structural and electrical changes in the heart.The study looked at the effects of ablation on the heart over time. Senior author Sandeep Jain, M.D., expressed optimism that the data from this research will lead to further investigation into the best therapies for patients with Afib. Other authors on the study included Jianhui Zhu Ph.D., Floyd Thoma, Steve Koscumb, Krishna Kancharla, M.D., Andrew Voigt, M.D., Jared Magnani, M.D., N. A. Estes, M.D., Samir Saba, M.D., Oscar Marroquin, M.D., and Suresh Mulukutla, M.D., all from UPMC.