Author Affiliations: Centre for Heart Rhythm Disorders, University of Adelaide and the Royal Adelaide Hospital, Adelaide, Australia.
We thank Dr Carter for his interest in our recently published report on nationwide trends in hospitalizations for atrial fibrillation (AF), heart failure, and myocardial infarction in Australia.1 His suspicion that similar trends may be present in the United States is indeed supported by recent reports that describe declining trends in heart failure hospitalizations and continuing increases in AF hospitalizations over comparable periods.2,3 We also suspect that, based on aging population structures in both Australia and North America, the incidence and burden of AF is likely to continue to increase.4 Hospitalizations are the major cost driver associated with AF, and preventing unnecessary presentations, or increasing outpatient management of stable cases, could certainly help in containing the economic burden of AF. In addition, however, a greater recognition and management of increasingly prevalent traditional and newer risk factors for AF is also required.5 We believe that only this will slow the rising incidence of AF and, with it, the associated morbidity, mortality, and economic burden that extends beyond hospitalizations.
Wong CX, Roberts-Thomson KC, Sanders P. The Burden of Hospitalization for Atrial Fibrillation—Reply. Arch Intern Med. 2012;172(22):1770. doi:10.1001/2013.jamainternmed.320
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