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Accumulation of chronic conditions in patients aged <65 years diagnosed with atrial fibrillation

Walker J Tordsen1, Peter S Salama1, Sheila M Manemann2

  • 1University of Minnesota Medical School, Minneapolis, Minnesota.

Heart Rhythm
|July 18, 2026
PubMed

Insights

Younger patients with atrial fibrillation (AF) accumulate chronic conditions faster than those without AF, especially within the first year post-diagnosis. This accelerated comorbidity burden highlights the need for proactive management in this demographic.

Area of Science:

  • Cardiology
  • Epidemiology
  • Gerontology

Background:

  • Multimorbidity is prevalent in atrial fibrillation (AF), particularly in older individuals with multiple cardiovascular (CV) and non-CV conditions.
  • Understanding comorbidity accumulation in younger AF patients is crucial for effective management.

Purpose of the Study:

  • To investigate the pattern and rate of chronic condition accumulation in patients under 65 diagnosed with AF.
  • To compare comorbidity burden in younger AF patients versus age- and sex-matched controls.

Main Methods:

  • A cohort of 3462 patients aged <65 with incident AF (2013-2019) was matched 1:1 to referents.
  • Onset of 20 chronic conditions (6 CV, 14 non-CV) was tracked from 3 years pre-index to 12/31/2022.
  • Andersen-Gill models analyzed associations between AF status and condition accumulation.

Main Results:

  • Patients with AF had a higher prevalence of chronic conditions at index compared to referents (75.2% vs. 67.7%).
  • Condition accumulation was significantly accelerated in AF patients, particularly within the first year post-diagnosis (CV: HR 3.80; non-CV: HR 2.42).
  • Accelerated CV condition accumulation was more pronounced in women and younger age groups (<55 years).

Conclusions:

  • Younger patients (<65) with AF experience a significantly increased accumulation of chronic conditions compared to non-AF individuals.
  • The first year following AF diagnosis is a critical period for accelerated comorbidity development in this population.
  • Findings underscore the importance of early and comprehensive management strategies for younger AF patients to address the rapid onset of multimorbidity.
Abstract

Keywords:
Atrial fibrillationAtrial flutterCardiovascularChronic conditionsElectronic health recordsMultimorbidity

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