AF statistics from Germany

WISMAR, GERMANY. It is by now generally accepted that the incidence and prevalence of atrial fibrillation (AF) is growing rapidly. A group of researchers from various German universities report that as many as 4.4% of men and 3.9% of women can expect to develop new-onset AF within any given year. Their study involved 8.3 million Germans whose health insurance data (doctor’s visits and hospital admissions) were examined for the years 2007 and 2008. Those diagnosed with AF were generally unhealthy with 87% having hypertension, 62% having heart failure or vascular disease, and 43% having diabetes – obviously not lone afibbers! Study participants were considered to have developed new-onset AF in 2008 if

  • they were free of AF in 2007;
  • they did not receive oral anticoagulation in 2007;
  • they had been diagnosed with AF in 2008, either in hospital or during at least two doctor’s visits.

The overall prevalence (number of people having AF in 2008) was 176,891 or 2.13% of the entire 8.3 million people involved in the study. Both incidence and prevalence of AF were found to increase sharply with age.

Age
Male, Prevalence(1)
Female, Prevalence(1)
Male, Incidence(2)
Female, Incidence(2)
15-49 years
1.2%
0.5%
0.5%
0.2%
50-64 years
6.8%
2.9%
1.5%
0.8%
65-74 years
15%
9.4%
2.7%
2.0%
75-84 years
28.6%
22.0%
4.7%
3.1%
85-89 years
17.7%
14.0%
3.3%
3.0%
(1) Total number of persons with AF in each age group at any given point in time
(2) Total new cases of AF diagnosed per year in each age group

It is clear from the study that women are substantially less affected by AF than are men and that the incidence (new diagnoses) increases sharply after age 65 for both genders. Based on their data, the researchers estimate that 1.8 million Germans were living with AF in 2009 including 363,000 newly diagnosed that year. They also predict that the number of AF patients in Germany will increase to 2.1 million by 2020 including 426,000 newly diagnosed cases. They conclude that, “in a large industrial nation such as Germany care provision structures are going to be challenged by a requirement to treat more AF patients in the future”.
Wilke, T, et al. Incidence and prevalence of atrial fibrillation: an analysis based on 8.3 million patients. Europace, Vol. 15, 2013, pp. 486-93

Editor’s comment: The German figures for prevalence (2.1%) and incidence (4.1%) are substantially higher than corresponding numbers reported in a 2008 study in Iceland (1.9% and 2.4%) and considerably higher than those reported in the United States (1% and 1%). It is interesting that, by far, the majority of new-onset AF occurred after the age of 65 in the German study. In contrast, only 7% of the 250 participants in our LAF Survey 14 were diagnosed after the age of 65 years. This adds to the evidence that lone AF is quite a different condition than AF with underlying heart disease. It also clearly shows that an aging population is not a significant driver of the lone AF epidemic.