Trends in Atrial Fibrillation-Related Mortality Among Adults With Obesity in the United States From 1999 to 2024

Atrial fibrillation (AF) is a prevalent cardiac arrhythmia associated with increased mortality, particularly among individuals with obesity. This study examined trends in AF-related mortality in adults with obesity in the United States from 1999 to 2024.

Trends in AF-related mortality in adults with obesity aged ≥ 25 years with obesity were analyzed using the Centers for Disease Control and Prevention Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) database. AF and obesity were considered as multiple causes of death. Age-adjusted mortality rates (AAMRs) per 1,000,000 were analyzed using Joinpoint regression to identify trends and calculate average annual percentage change (AAPC) stratified by gender, race, and region.

A total of 63,853 deaths were identified. From 1999 to 2024, AF-related mortality rates increased from 1.9 in 1999 to 20.8 in 2024 (AAPC: 11.4 [95% CI: 10.4, 12.2]). Males recorded higher AAMRs than females. White individuals exhibited higher AAMRs than Blacks. Nonmetropolitan areas (9.6) had higher AAMR than metropolitan areas (7.4). The Midwest recorded the highest AAMR while the South reported the steepest rise. States in the top 90th percentile of AAMR were Vermont, Oklahoma, Oregon, Minnesota, and Wyoming.

AF- and obesity-related mortality has increased overall from 1999 to 2024, with higher mortality rates observed in men, White individuals, nonmetropolitan areas, and the Southern US region. These findings highlight the need for continued surveillance and targeted prevention efforts in this population.