Heart Failure Is the Most Common Complication of Atrial Fibrillation

More patients with atrial fibrillation (AFib) are likely to experience heart failure as a complication, according to a new study published in The BMJ. The findings underline the need to develop preventive measures for people living with AFib.

AFib is estimated to affect 40 million people across the United States and Europe by 2060. Traditionally, care for patients with AFib has primarily focused on the risk of stroke. Other complications, such as heart failure and heart attack, have yet to be fully explored. To address this knowledge gap, investigators assessed national data for 3.5 million adults aged 45 years or older with no history of AFib to see whether they developed the condition over a 23-year period (2000-2022).

The analysis comprised 362,721 individuals with a new diagnosis of AFib during this study period. Patients were 46% women, 54% men, and had no complications. Researchers followed the population of interest until a diagnosis of heart failure, stroke, or heart attack.

According to the results, the lifetime risk of AFib increased from 24% in 2000-2010 to 31% in 2011-2022. Notably, among those with AFib, the most common complication was heart failure (lifetime risk, 41%), a risk observed to be twice as high as the lifetime risk of any stroke (21%) and 4 times greater than the lifetime risk of heart attack (12%).

“Our novel quantification of the long-term downstream consequences of atrial fibrillation highlights the critical need for treatments to further decrease stroke risk, as well as for heart failure prevention strategies among patients with atrial fibrillation,” the researchers concluded.