Epidemiology of major heart rhythm and conduction disorders.

Abstract

Background: Heart rhythm and conduction disorders cover a variety of pathologies, ranging from the benign to the immediately life threatening.

Aims: To describe the epidemiology of patients hospitalized for arrhythmias in France, and to estimate the prevalence and mortality associated with these disorders, divided into three separate groups: atrial fibrillation and flutter; conduction disorders; and ventricular tachycardia/cardiac arrest.

Methods: We looked in the National Health Data System and selected patients who had been hospitalized at least once in 2022 for these diseases and patients who died as a result of these diseases in 2021. The prevalence of these disorders among people alive on 1st January 2023 was estimated by combining previous hospitalizations and people in receipt of 100% coverage for a registered long-term disease.

Results: At 1st January 2023, the prevalence of patients who had been hospitalized with major rhythm and conduction disorders was 2,740,141: 2,027,900 with atrial fibrillation/flutter; 999,692 with conduction disorders; and 214,989 with ventricular tachycardia/cardiac arrest. In 2022, respectively 90,502, 48,268 and 16,930 were hospitalized for these conditions, which equate to rates of 169.5, 68.3, and 31.7 per 100,000 inhabitants, respectively. Several departments in the Hauts-de-France and Grand-Est regions had rates>20% above the national rate. The rate of ventricular tachycardia/cardiac arrest was 40% higher among residents of the most deprived municipalities than among residents of the least deprived municipalities. Mortality at the end of hospitalization reached 44% for patients hospitalized for ventricular tachycardia/cardiac arrest.

Conclusions: Arrhythmias and conduction disorders affect a significant proportion of the population, leading to a large number of hospitalizations and procedures, particularly ablation techniques and pacemaker/defibrillator implantation. Given the extent of regional disparities and the impact of the socioeconomic status of the municipality of residence, targeted prevention and screening strategies should be implemented.