Epidemiology of Atrial Fibrillation and Related Myocardial Ischemia Events in Chinese Community Population in 2019 (Preprint)

BACKGROUND Atrial fibrillation is the most common arrhythmia, and the incidence increases rapidly all over the world. The global prevalence of atrial fibrillation (age-adjusted) is 0·60% for men and 0·37% for women. The prevalence situation of atrial fibrillation(age-adjusted) in China is 0·65%, and it is expected that the number of patients with atrial fibrillation will continue to rise in the future worldwide due to population aging. OBJECTIVE To explore the prevalence of atrial fibrillation in Chinese community population in 2019 and clarify the prevalence of atrial fibrillation complicated with other arrhythmias and myocardial ischemia events. METHODS The remote ECG diagnosis system of Xinhua Hospital was assessed to screen participants with ECG evidence of AF from Jan 1, 2019 to Dec 31, 2019. The prevalence rates of atrial fibrillation and its association with other arrhythmias and myocardial ischemia events were analyzed and subgroup analysis was performed between different gender and age groups. RESULTS A total of 22016 AF cases were identified out of all ECGs derived from the remote ECG diagnosis system in 2019. The prevalence rate of atrial fibrillation in the remote ECG diagnosis platform in 2019 was about 2.75%(95%CI 2.71%-2.78%). The prevalence rate of atrial fibrillation in males was higher than that in females (p<0.001), and the ventricular rate was faster in female patients (p<0.001). The prevalence rate of atrial fibrillation in participants aged 65 or above was higher than that in participants under 65 years old (p<0.001) and the ventricular rate was lower in aged group (p<0.001). Atrial fibrillation with lower ventricular rate is associated with increased prevalence of third-degree atrioventricular block (p<0.001). CONCLUSIONS According to these results, it is estimated that the number of patients with atrial fibrillation in China are around 7.98 million in 2019. The analysis of different genders suggests the necessity of the monitoring on ventricular rate in elderly male patients with atrial fibrillation to timely recognize severe arrhythmias.