Shaan Khurshid1, Seung Hoan Choi2, Lu-Chen Weng2, Elizabeth Y Wang2, Ludovic Trinquart3,4, Emelia J Benjamin4,5,6, Patrick T Ellinor2,7, Steven A Lubitz8,7. 1. Division of Cardiology (S.K.). 2. Cardiovascular Research Center (S.H.C., L.-C.W., E.Y.W., P.T.E., S.A.L.). 3. Massachusetts General Hospital, Boston. Department of Biostatistics, Boston University School of Public Health, MA (L.T.). 4. Boston University and National Heart, Lung, and Blood Institute's Framingham Heart Study, MA (L.T., E.J.B.). 5. Sections of Preventive Medicine and Cardiovascular Medicine, Department of Medicine, Boston University School of Medicine, MA (E.J.B.). 6. Department of Epidemiology, Boston University School of Public Heath, MA (E.J.B.). 7. Cardiac Arrhythmia Service (P.T.E., S.A.L.). 8. Cardiovascular Research Center (S.H.C., L.-C.W., E.Y.W., P.T.E., S.A.L.) slubitz@mgh.harvard.edu.
Abstract
BACKGROUND: The frequency of cardiac rhythm abnormalities and their risk factors in community-dwelling adults are not well characterized. METHODS: We determined the frequency of rhythm abnormalities in the UK Biobank, a national prospective cohort. We tested associations between risk factors and incident rhythm abnormalities using multivariable proportional hazards regression. RESULTS: Of 502 627 adults (median age, 58 years [interquartile range, 13]; 54.4% women), 2.35% had a baseline rhythm abnormality. The prevalence increased with age with 4.84% of individuals aged 65 to 73 years affected. During 3 368 332 person-years of follow-up, 15 906 new rhythm abnormalities were detected (4.72 per 1000 person-years; 95% confidence interval [CI]: 4.65-4.80). Atrial fibrillation (3.11 per 1000 person-years; 95% CI: 3.05-3.17), bradyarrhythmias (0.89 per 1000 person-years; 95% CI: 0.86-0.92), and conduction system diseases (1.06 per 1000 person-years; 95% CI: 1.02-1.09) were more common than supraventricular (0.51 per 1000 person-years; 95% CI: 0.48-0.53) and ventricular arrhythmias (0.57 per 1000 person-years; 95% CI: 0.55-0.60). Older age (hazard ratio [HR]: 2.35 per 10-year increase; 95% CI: 2.29-2.41; P<0.01), male sex (HR: 1.83; 95% CI: 1.76-1.89; P<0.01), hypertension (HR: 1.49; 95% CI: 1.44-1.54; P<0.01), chronic kidney disease (HR: 1.95; 95% CI: 1.67-2.27; P<0.01), and heart failure (HR: 1.99; 95% CI: 1.76-2.26; P<0.01) were associated with new rhythm abnormalities. CONCLUSIONS: The frequency of rhythm abnormalities in middle-aged to older community-dwelling adults is substantial. Atrial fibrillation, bradyarrhythmias, and conduction system diseases account for most rhythm conditions.
BACKGROUND: The frequency of cardiac rhythm abnormalities and their risk factors in community-dwelling adults are not well characterized. METHODS: We determined the frequency of rhythm abnormalities in the UK Biobank, a national prospective cohort. We tested associations between risk factors and incident rhythm abnormalities using multivariable proportional hazards regression. RESULTS: Of 502 627 adults (median age, 58 years [interquartile range, 13]; 54.4% women), 2.35% had a baseline rhythm abnormality. The prevalence increased with age with 4.84% of individuals aged 65 to 73 years affected. During 3 368 332 person-years of follow-up, 15 906 new rhythm abnormalities were detected (4.72 per 1000 person-years; 95% confidence interval [CI]: 4.65-4.80). Atrial fibrillation (3.11 per 1000 person-years; 95% CI: 3.05-3.17), bradyarrhythmias (0.89 per 1000 person-years; 95% CI: 0.86-0.92), and conduction system diseases (1.06 per 1000 person-years; 95% CI: 1.02-1.09) were more common than supraventricular (0.51 per 1000 person-years; 95% CI: 0.48-0.53) and ventricular arrhythmias (0.57 per 1000 person-years; 95% CI: 0.55-0.60). Older age (hazard ratio [HR]: 2.35 per 10-year increase; 95% CI: 2.29-2.41; P<0.01), male sex (HR: 1.83; 95% CI: 1.76-1.89; P<0.01), hypertension (HR: 1.49; 95% CI: 1.44-1.54; P<0.01), chronic kidney disease (HR: 1.95; 95% CI: 1.67-2.27; P<0.01), and heart failure (HR: 1.99; 95% CI: 1.76-2.26; P<0.01) were associated with new rhythm abnormalities. CONCLUSIONS: The frequency of rhythm abnormalities in middle-aged to older community-dwelling adults is substantial. Atrial fibrillation, bradyarrhythmias, and conduction system diseases account for most rhythm conditions.
Authors: Yoko Miyasaka; Marion E Barnes; Bernard J Gersh; Stephen S Cha; Kent R Bailey; Walter P Abhayaratna; James B Seward; Teresa S M Tsang Journal: Circulation Date: 2006-07-03 Impact factor: 29.690
Authors: L A Orejarena; H Vidaillet; F DeStefano; D L Nordstrom; R A Vierkant; P N Smith; J J Hayes Journal: J Am Coll Cardiol Date: 1998-01 Impact factor: 24.094
Authors: Renate B Schnabel; Xiaoyan Yin; Philimon Gona; Martin G Larson; Alexa S Beiser; David D McManus; Christopher Newton-Cheh; Steven A Lubitz; Jared W Magnani; Patrick T Ellinor; Sudha Seshadri; Philip A Wolf; Ramachandran S Vasan; Emelia J Benjamin; Daniel Levy Journal: Lancet Date: 2015-05-07 Impact factor: 79.321
Authors: Cathie Sudlow; John Gallacher; Naomi Allen; Valerie Beral; Paul Burton; John Danesh; Paul Downey; Paul Elliott; Jane Green; Martin Landray; Bette Liu; Paul Matthews; Giok Ong; Jill Pell; Alan Silman; Alan Young; Tim Sprosen; Tim Peakman; Rory Collins Journal: PLoS Med Date: 2015-03-31 Impact factor: 11.069
Authors: Alvaro Alonso; Bouwe P Krijthe; Thor Aspelund; Katherine A Stepas; Michael J Pencina; Carlee B Moser; Moritz F Sinner; Nona Sotoodehnia; João D Fontes; A Cecile J W Janssens; Richard A Kronmal; Jared W Magnani; Jacqueline C Witteman; Alanna M Chamberlain; Steven A Lubitz; Renate B Schnabel; Sunil K Agarwal; David D McManus; Patrick T Ellinor; Martin G Larson; Gregory L Burke; Lenore J Launer; Albert Hofman; Daniel Levy; John S Gottdiener; Stefan Kääb; David Couper; Tamara B Harris; Elsayed Z Soliman; Bruno H C Stricker; Vilmundur Gudnason; Susan R Heckbert; Emelia J Benjamin Journal: J Am Heart Assoc Date: 2013-03-18 Impact factor: 5.501
Authors: Louis Gerges; Kyla D'Angelo; David Bass; Arezoo Haghshenas; Daniel J Kersten; Manmeet Ahluwalia; Roman Zelster; Amgad N Makaryus Journal: Am J Cardiovasc Dis Date: 2022-02-15
Authors: Shaan Khurshid; Samuel Friedman; Christopher Reeder; Paolo Di Achille; Nathaniel Diamant; Pulkit Singh; Lia X Harrington; Xin Wang; Mostafa A Al-Alusi; Gopal Sarma; Andrea S Foulkes; Patrick T Ellinor; Christopher D Anderson; Jennifer E Ho; Anthony A Philippakis; Puneet Batra; Steven A Lubitz Journal: Circulation Date: 2021-11-08 Impact factor: 29.690
Authors: Parag Ravindra Gajendragadkar; Adam Von Ende; Maysson Ibrahim; Elsa Valdes-Marquez; Christian Fielder Camm; Federico Murgia; Alexander Stiby; Barbara Casadei; Jemma C Hopewell Journal: PLoS Med Date: 2021-05-13 Impact factor: 11.069
Authors: Jennifer L Halford; Lu-Chen Weng; Seung Hoan Choi; Sean J Jurgens; Valerie N Morrill; Shaan Khurshid; Ludovic Trinquart; Emelia J Benjamin; Patrick T Ellinor; Steven A Lubitz Journal: Circ Genom Precis Med Date: 2020-11-06