Mhanna Mohammed, Al-Abdouh Ahmad, Alzahrani Ashraf, Jabri Ahmad, Al-Harbi Abdulmajeed, Beran Azizullah, Barbarawi Mahmoud, Mansour Shareef, Dominic Paari
Division of Cardiology, Department of Medicine University of Iowa Iowa City IA USA.
Department of Internal Medicine University of Kentucky Lexington KY USA.
J Am Heart Assoc. 2025 Jun 17;14(12):e039615. doi: 10.1161/JAHA.124.039615. Epub 2025 Jun 11.
Arrhythmias are a significant public health concern, and understanding their evolving patterns is vital for informed health care planning. This study explores trends and disparities in arrhythmia-related mortality rates in the United States from 1968 to 2021, projecting up to 2040.
We examined national death records for cardiovascular deaths linked to arrhythmia among individuals aged 15 to 84 years, using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research. Age-adjusted mortality rates (AAMRs) were calculated, and trends were evaluated. Subgroup analyses were conducted on the basis of arrhythmia subtypes, age, sex, race, and geographic regions. AAMRs for 2040 were projected using Autoregressive Integrated Moving Average forecasting.
Overall AAMRs increased from 1968 to 2021, peaking in 1988 before declining, then slightly increasing after 2006. Atrial fibrillation- or flutter-related fatalities surpassed cardiac arrest-related deaths after 2006. Sex disparities decreased, with men maintaining higher crude mortality rates, but the gap narrowed. Younger populations witnessed an upward trend in AAMRs after 2006. Racial disparities persisted, with Black populations experiencing higher AAMRs than White populations.
This study provides insights into evolving arrhythmia-related death. While overall AAMRs may stabilize by 2040, the projected rise in atrial fibrillation-related deaths, particularly among younger populations, necessitates further investigation. Additional research is needed to determine whether this trend reflects a true epidemiologic shift or improvements in detection and reporting. Furthermore, identifying underlying risk factors and developing targeted interventions will be crucial in mitigating AF-related death in younger adults. Persistent racial disparities underscore the importance of equitable health care strategies.
心律失常是一个重大的公共卫生问题，了解其演变模式对于制定明智的医疗保健计划至关重要。本研究探讨了1968年至2021年美国心律失常相关死亡率的趋势和差异，并预测至2040年。
我们使用疾病控制与预防中心的广泛在线流行病学研究数据，检查了15至84岁人群中心血管死亡与心律失常相关的全国死亡记录。计算年龄调整死亡率（AAMR）并评估趋势。根据心律失常亚型、年龄、性别、种族和地理区域进行亚组分析。使用自回归积分移动平均预测法预测2040年的AAMR。
总体AAMR从1968年至2021年有所上升，1988年达到峰值后下降，2006年后略有上升。2006年后，心房颤动或扑动相关死亡超过心脏骤停相关死亡。性别差异减小，男性的粗死亡率仍然较高，但差距缩小。2006年后，较年轻人群的AAMR呈上升趋势。种族差异依然存在，黑人人群的AAMR高于白人人群。
本研究为心律失常相关死亡的演变提供了见解。虽然到2040年总体AAMR可能会稳定下来，但预计心房颤动相关死亡的上升，特别是在较年轻人群中，需要进一步调查。需要更多研究来确定这一趋势是否反映了真正的流行病学转变或检测和报告方面的改善。此外，识别潜在风险因素并制定有针对性的干预措施对于减轻年轻成年人中与房颤相关的死亡至关重要。持续存在的种族差异凸显了公平医疗保健策略的重要性。
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