Abstract
Background
Atrial fibrillation (AF) is the most common sustained atrial arrhythmia and it is independently associated with an increased morbidity and mortality. As a result of the high prevalence of AF, the economic and clinical impact of the disease is substantial. This study describes the economic and clinical impact of AF in the Netherlands.
Methods
Epidemiological data on AF in the Netherlands were projected on population estimates of the Netherlands in 2009 and combined with data on the cost of AF and its interventions.
Results
Overall prevalence of AF in the Netherlands is 5.5% in the population over 55 years, corresponding to about 250,000 AF patients. The prevalence increases with age, and the mean age of AF patients is 69.3 years. Incidence of AF in the Netherlands varies with age, from 1188 new cases in the age group of 55 to 59 up to 7074 new cases in the age group 75 to 79. Total new cases amounts to 45,085 patients per year in the Netherlands. Total costs of AF in the Netherlands are € 583 million, of which the majority (70%) were accounted for by hospitalisations and in-hospital procedures. Pharmacotherapeutic management of AF totalled € 17 million in the Netherlands in 2009.
Discussion
AF is a serious disease with a high clinical and economic burden, especially due to hospitalisations as a result of cardiovascular events. The number of patients with AF in the Netherlands is considerable and will increase with the ageing population in the future.
Similar content being viewed by others
References
Benjamin EJ, Levy D, Vaziri SM, et al. Independent risk factors for atrial fibrillation in a population-based cohort. The Framingham Heart Study. JAMA. 1994;271(11):840–4.
Kannel WB, Wolf PA, Benjamin EJ, et al. Prevalence, incidence, prognosis, and predisposing conditions for atrial fibrillation: population-based estimates. Am J Cardiol. 1998;82(8A):2N–9N.
Stewart S, Hart CL, Hole DJ, et al. A population-based study of the long-term risks associated with atrial fibrillation: 20-year follow-up of the Renfrew/Paisley study. Am J Med. 2002;113(5):359–64.
Kirchhof P, Bax J, Blomstrom-Lundquist C, et al. Early and comprehensive management of atrial fibrillation: proceedings from the 2nd AFNET/EHRA consensus conference on atrial fibrillation entitled ‘research perspectives in atrial fibrillation’. Europace. 2009;11(7):860–85.
Miyasaka Y, Barnes ME, Gersh BJ, et al. Secular trends in incidence of atrial fibrillation in Olmsted County, Minnesota, 1980 to 2000, and implications on the projections for future prevalence. Circulation. 2006;114(2):119–25.
Nieuwlaat R, Capucci A, Camm AJ, et al. Atrial fibrillation management: a prospective survey in ESC member countries: the Euro Heart Survey on Atrial Fibrillation. Eur Heart J. 2005;26(22):2422–34.
McBride D, Mattenklotz AM, Willich SN, et al. The costs of care in atrial fibrillation and the effect of treatment modalities in Germany. Value Health. 2008;12(2):293–301.
Moeremans K, Aliot E, de Chillou C, et al. Second line pharmacological management of paroxysmal and persistent atrial fibrillation in France: a cost analysis. Value Health. 2000;3(6):407–16.
Stewart S, Murphy NF, Walker A, et al. Cost of an emerging epidemic: an economic analysis of atrial fibrillation in the UK. Heart. 2004;90(3):286–92.
Reynolds MR, Essebag V, Zimetbaum P, et al. Healthcare resource utilization and costs associated with recurrent episodes of atrial fibrillation: the FRACTAL registry. J Cardiovasc Electrophysiol. 2007;18(6):628–33.
Ringborg A, Nieuwlaat R, Lindgren P, et al. Costs of atrial fibrillation in five European countries: results from the Euro Heart Survey on atrial fibrillation. Europace. 2008;10(4):403–11.
Camm AJ, Kirchhof P, Lip GY, et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery. Eur Heart J. 2010;31(19):2369–429.
Benjamin EJ, Wolf PA, D’Agostino RB, et al. Impact of atrial fibrillation on the risk of death: the Framingham Heart Study. Circulation. 1998;98(10):946–52.
Rho RW, Page RL. Asymptomatic atrial fibrillation. Prog Cardiovasc Dis. 2005;48(2):79–87.
Gage BF, Waterman AD, Shannon W, et al. Validation of clinical classification schemes for predicting stroke: results from the National Registry of Atrial Fibrillation. JAMA. 2001;285(22):2864–70.
Wolf PA, Abbott RD, Kannel WB. Atrial fibrillation as an independent risk factor for stroke: the Framingham Study. Stroke. 1991;22(8):983–8.
Go AS, Hylek EM, Phillips KA, et al. Prevalence of diagnosed atrial fibrillation in adults: national implications for rhythm management and stroke prevention: the AnTicoagulation and Risk Factors in Atrial Fibrillation (ATRIA) Study. JAMA. 2001;285(18):2370–5.
Lin HJ, Wolf PA, Kelly-Hayes M, et al. Stroke severity in atrial fibrillation. The Framingham Study. Stroke. 1996;27(10):1760–4.
Sandercock P, Bamford J, Dennis M, et al. Atrial fibrillation and stroke: prevalence in different types of stroke and influence on early and long term prognosis (Oxfordshire community stroke project). BMJ. 1992;305(6867):1460–5.
Marini C, De Santis F, Sacco S, et al. Contribution of atrial fibrillation to incidence and outcome of ischemic stroke: results from a population-based study. Stroke. 2005;36(6):1115–9.
Kaarisalo MM, Immonen-Räihä P, Marttila RJ, et al. Atrial fibrillation and stroke. Mortality and causes of death after the first acute ischemic stroke. Stroke. 1997;28(2):311–5.
Efremidis M, Pappas L, Sideris A, et al. Management of atrial fibrillation in patients with heart failure. J Card Fail. 2008;14(3):232–7.
Wang TJ, Larson MG, Levy D, et al. Temporal relations of atrial fibrillation and congestive heart failure and their joint influence on mortality: the Framingham Heart Study. Circulation. 2003;107(23):2920–5.
Nieuwlaat R, Prins MH, Le Heuzey JY, et al. Prognosis, disease progression, and treatment of atrial fibrillation patients during 1 year: follow-up of the Euro Heart Survey on atrial fibrillation. Eur Heart J. 2008;29(9):1181–9.
Conen D, Osswald S, Albert CM. Epidemiology of atrial fibrillation. Swiss Med Wkly. 2009;139(25–26):346–52.
Healey JS, Connolly SJ. Atrial fibrillation: hypertension as a causative agent, risk factor for complications, and potential therapeutic target. Am J Cardiol. 2003;91(10A):9G–14G.
Heeringa J, van der Kuip DA, Hofman A, et al. Prevalence, incidence and lifetime risk of atrial fibrillation: the Rotterdam study. Eur Heart J. 2006;27(8):949–53.
Reynolds MR, Ellis E, Zimetbaum P. Quality of life in atrial fibrillation: measurement tools and impact of interventions. J Cardiovasc Electrophysiol. 2008;19(7):762–8.
Kang Y. Relation of atrial arrhythmia-related symptoms to health-related quality of life in patients with newly diagnosed atrial fibrillation: a community hospital-based cohort. Heart Lung. 2006;35(3):170–7.
Howes CJ, Reid MC, Brandt C, et al. Exercise tolerance and quality of life in elderly patients with chronic atrial fibrillation. J Cardiovasc Pharmacol Ther. 2001;6(1):23–9.
Reynolds MR, Lavelle T, Essebag V, et al. Influence of age, sex, and atrial fibrillation recurrence on quality of life outcomes in a population of patients with new-onset atrial fibrillation: the Fibrillation Registry Assessing Costs, Therapies, Adverse events and Lifestyle (FRACTAL) study. Am Heart J. 2006;152(6):1097–103.
Furberg CD, Psaty BM, Manolio TA, et al. Prevalence of atrial fibrillation in elderly subjects (the Cardiovascular Health Study). Am J Cardiol. 1994;74(3):236–41.
Nederlands Huisartsen Genootschap. NHG-standaard atriumfibrilleren M79. 2009. Available from: http://nhg.artsennet.nl/kenniscentrum/k_richtlijnen/k_nhgstandaarden/Samenvattingskaartje-NHGStandaard/M79_svk.htm. Accessed 23 Dec 2009.
Corley SD, Epstein AE, DiMarco JP, et al. Relationships between sinus rhythm, treatment, and survival in the Atrial Fibrillation Follow-Up Investigation of Rhythm Management (AFFIRM) Study. Circulation. 2004;109(12):1509–13.
Wyse DG, Waldo AL, DiMarco JP, et al. A comparison of rate control and rhythm control in patients with atrial fibrillation. N Engl J Med. 2002;347(23):1825–33.
Burkhardt JD, Natale A. New technologies in atrial fibrillation ablation. Circulation. 2009;120(15):1533–41.
Fisher JD, Spinelli MA, Mookherjee D, et al. Atrial fibrillation ablation: reaching the mainstream. Pacing Clin Electrophysiol. 2006;29(5):523–37.
Ehrlich JR, Nattel S. Novel approaches for pharmacological management of atrial fibrillation. Drugs. 2009;69(7):757–74.
Gezondheid en zorg in cijfers 2009. Centraal Bureau voor de Statistiek. Dec 2009. Available from: http://www.cbs.nl/nl-NL/menu/themas/gezondheid-welzijn/publicaties/publicaties/archief/2009/2009-c156-pub.htm. Accessed 5 Jan 2010.
College voor Zorgverzekeringen. www.medicijnkosten.nl. Accessed 5 Jan 2010.
Funding
This study was funded by Sanofi-Aventis. The authors were independent from Sanofi-Aventis in the conduct and the reporting of this study.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Heemstra, H.E., Nieuwlaat, R., Meijboom, M. et al. The burden of atrial fibrillation in the Netherlands. Neth Heart J 19, 373–378 (2011). https://doi.org/10.1007/s12471-011-0175-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12471-011-0175-4