Ten years differences in recently onset atrial fibrillation and flutter incidence and management

Objects and background: Atrial fibrillation (AF) and atrial flutter (AFl) are the most common arrhythmias in day-life clinical practice. Purpose of our study was to verify differences occurred in the last ten years in AF and AFl incidence and treatment in the emergency room (ER). Methods: from the 17th January to the 15th February 2000 and from the 18th January to the 16th February 2010 all the consecutive patients with AF or AFl referring to the ER of our hospital were included in the study. Epidemiological data were collected along with information about treatment, admission to hospital wards, days of hospital stay and therapy. Data from the year 2000 were compared to these collected ten years later. Results: incidence of AF and AFl has increased in the years (50%), patients are older (73.5 vs. 65.2 years; p 0.029) and refer late to the ER (45.6% in 2010 and 23.7% in 2000 with a delay of > 48 hours from arrhythmias onset; p 0.054). In 2010 only a minority of these patients is directly discharged from the ER (15.8% vs 14.4%) and there is an increased admission rate due to AF or AFl (67.5%; p 0.026), if compared to the whole admissions of the hospital. The median duration of hospital stay decreased from 6 days to 4.5 days in the year 2010 (NS). Conclusion: AF and AFl incidence is still increasing and account for a high admission rate from the ER to the hospital wards. Costs are consequently continuously increasing.