Impact of New Onset Atrial Fibrillation on Life Expectancy and Treatment Approach

Effect on Life Expectancy

Atrial fibrillation doubles death rates independently of other known predictors of mortality, affecting patients with atrial fibrillation, according to the European Society of Cardiology 1, 2
Atrial fibrillation is associated with increased risk of stroke and thromboembolic events, heart failure and hospitalizations, cognitive dysfunction and vascular dementia, and reduced quality of life and exercise capacity, in the general population with atrial fibrillation 1, 2, 3
Atrial fibrillation-related strokes are particularly severe, resulting in higher rates of fatality, greater disability in survivors, higher recurrence rates, doubled risk of death from stroke, and 1.5-fold increase in cost of care, as reported by the European Heart Journal 1

The European Society of Cardiology recommends rate control with chronic anticoagulation as the primary treatment approach for most patients with atrial fibrillation 4
Major clinical trials have demonstrated no significant difference in overall mortality between rate control and rhythm control strategies, no difference in stroke rates, more hospitalizations in rhythm-control groups, and similar quality-of-life measures in both strategies, according to the American College of Cardiology 4, 5
Anticoagulation is the only therapy proven to reduce atrial fibrillation-related deaths, and should be based on stroke risk assessment, as recommended by the European Heart Journal 1, 2
Direct oral anticoagulants are recommended over vitamin K antagonists in eligible patients, according to the European Society of Cardiology 6

Certain patient populations, such as younger patients with structurally normal hearts, patients with symptomatic paroxysmal atrial fibrillation, and patients with heart failure with reduced ejection fraction, may benefit from rhythm control strategies, as suggested by the American Heart Association 4, 6
Rhythm control should be considered within 12 months of diagnosis in selected patients at risk of thromboembolic events, according to the European Society of Cardiology 6

Management of comorbidities, such as hypertension, diabetes, and sleep apnea, is essential for patients with atrial fibrillation, as recommended by the European Society of Cardiology 2, 8

Discontinuation of anticoagulation is associated with increased stroke risk, even in patients with rhythm control, as reported by the American College of Cardiology 4, 5
Paroxysmal atrial fibrillation carries the same stroke risk as persistent or permanent atrial fibrillation, according to the European Heart Journal 1
Rhythm control strategies do not eliminate the need for anticoagulation in patients with risk factors for stroke, as recommended by the American Heart Association 4, 5