Li Cheng, Wang Haicheng, Li Mohan, Qiu Xiangjun, Wang Qunshan, Sun Jian, Yang Mei, Feng Xiangfei, Meng Shu, Zhang Pengpai, Liu Bo, Li Wei, Chen Mu, Zhao Yan, Zhang Rui, Mo Binfeng, Zhu Yuling, Zhou Baohong, Chen Min, Liu Xia, Zhao Yuelin, Shen Mingzhen, Huang Jinkang, Luo Li, Wu Hong, Li Yi-Gang
Department of Cardiology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Shanghai Siwei Medical Co. Ltd., Shanghai, China.
Front Cardiovasc Med. 2022 Apr 4;9:821960. doi: 10.3389/fcvm.2022.821960. eCollection 2022.
Atrial fibrillation (AF) is the most common arrhythmia, and the incidence increases rapidly all over the world. The global prevalence of AF (age-adjusted) is 0.60% for men and 0.37% for women and the prevalence of AF in China is 0.65%. It is expected that the number of patients with AF will continue to rise in the future worldwide due to population aging.
To explore the prevalence of AF in Chinese community population in 2019 and clarify the prevalence of AF complicated with other arrhythmias and myocardial ischemia (MI) events.
The remote electrocardiogram (ECG) diagnosis system of Xinhua Hospital was assessed to the screen participants with ECG evidence of AF between January 1 and December 31, 2019. The prevalence rates of AF and its association with other arrhythmias and MI events were analyzed and subgroup analysis was performed between different sexes and age groups.
A total of 22,016 AF cases were identified out of all ECGs derived from the remote ECG diagnosis system in 2019. It is estimated that AF was presented in nearly 10.15 million people in China (age-adjusted standardized rate 0.72%, 95% CI 0.20-1.25%) in 2019 and 62% of the AF cases (6.27 million) affected people aged 65 years and above (age-adjusted standardized rate 3.56%, 95% CI 3.28-3.85%). The prevalence rate of AF in males was higher than that in females ( < 0.001), and the ventricular rate of AF patients was faster in females ( < 0.001) and younger patients ( < 0.001). AF patients with lower ventricular rate (under 60 beats per min) were associated with increased prevalence of ventricular escape/escape rhythm [ < 0.001, odds ratio (OR) 5.14] and third-degree atrioventricular block ( < 0.001, OR 32.05).
The prevalence of AF is higher in the Chinese community population than that was previously reported. AF patients complicated with ECG patterns suggesting myocardial infarction is common in men, and stricter measures should be taken to control the common risk factors of AF and coronary heart disease. It is also important that more attention should be paid to recognize fatal arrhythmias, especially in elderly male patients with AF.
心房颤动（AF）是最常见的心律失常，在全球范围内发病率迅速上升。全球AF（年龄调整后）的患病率男性为0.60%，女性为0.37%，中国AF的患病率为0.65%。由于人口老龄化，预计未来全球AF患者数量将持续增加。
探讨2019年中国社区人群中AF的患病率，并明确AF合并其他心律失常及心肌缺血（MI）事件的患病率。
对新华医院的远程心电图（ECG）诊断系统进行评估，以筛查出2019年1月1日至12月31日期间有ECG证据显示AF的参与者。分析AF的患病率及其与其他心律失常和MI事件的关联，并在不同性别和年龄组之间进行亚组分析。
在2019年远程ECG诊断系统导出的所有ECG中，共识别出22016例AF病例。据估计，2019年中国近1015万人患有AF（年龄调整后标准化率0.72%，95%CI 0.20 - 1.25%），其中62%的AF病例（627万）为65岁及以上人群（年龄调整后标准化率3.56%，95%CI 3.28 - 3.85%）。男性AF患病率高于女性（<0.001），女性AF患者的心室率更快（<0.001），年轻患者也是如此（<0.001）。心室率较低（每分钟低于60次）的AF患者，心室逸搏/逸搏心律的患病率增加（<0.001，比值比（OR）5.14）和三度房室传导阻滞的患病率增加（<0.001，OR 32.05）。
中国社区人群中AF的患病率高于先前报道。AF合并提示心肌梗死的ECG模式在男性中常见，应采取更严格的措施控制AF和冠心病的常见危险因素。同样重要的是，应更加重视识别致命性心律失常，尤其是老年男性AF患者。
