Atrial fibrillation

Metadata

Name	Atrial fibrillation (AF)
Category	Cardiovascular
Sex
Adult	Yes
UUID	39319f3d-9e11-4f39-bb6f-85591dad1041
Definition	A heart conduction disease that is characterized by uncoordinated electrical activity in the heart’s upper chambers (the atria), which causes the heartbeat to become fast and irregular and has symptoms palpitations, weakness, fatigue, lightheadedness, dizziness, confusion, shortness of breath and chest pain.

Ontologies

Disease Ontology (DOID)	DOID_0060224
GWAS Catalogue	EFO_0000275
MeSH	D001281
SNOMED-CT	49436004
FinnGen	I9_AF

Key Summary Statistics

Cases from any source

Total	36619
Female (%)	13383 (37%)
Male (%)	23236 (63%)

Year first recorded

Cases linked in all UK Biobank sources

Cross-source concordance

Vertical bars correspond to number of cases per source/intersection; horizontal bars to left correspond to total number of cases per source.

Incidence & prevalence

Baseline prevalence stratified by sex

Female	130.02 (122.4,137.64)
Male	343.12 (329.77,356.47)

Incidence stratified by sex

Female	22.79 (21.54,24.05)
Male	51.91 (49.81,54.01)

Incidence stratified by age

Ages 40-44	4.95 (3.56,6.33)
Ages 45-49	9.05 (7.43,10.66)
Ages 50-54	18.83 (16.67,20.98)
Ages 55-59	25.69 (23.4,27.98)
Ages 60-64	47.33 (44.64,50.03)
Ages 65-69	80.81 (76.72,84.91)

Period prevalence

Methods

Comparison with general population

Sex-standardised prevalence from CALIBER study (Kuan et al. 2019)

Population	Ages 40-49	Ages 50-59	Ages 60-69
UK Biobank	87 (78,96)	239 (227,251)	665 (648,683)
CALIBER	73 (71,75)	213 (209,217)	643 (635,651)

Stratified by age and Townsend deprivation status

Deprivation status	Ages 40-49	Ages 50-59	Ages 60-69
Least deprived	101(79,129)	202(177,229)	627(591,663)
Low	76(57,100)	234(207,263)	643(608,680)
Medium	84(64,108)	229(203,258)	632(596,670)
High	82(64,104)	249(222,278)	650(612,690)
Most deprived	87(70,108)	277(250,308)	797(753,843)

Stratified by age and country

Country	Ages 40-49	Ages 50-59	Ages 60-69
England	88(78,98)	242(228,256)	667(649,687)
Scotland	77(54,107)	222(191,257)	646(598,697)
Wales	89(58,132)	236(196,283)	674(613,739)

Risk factors analysis

‘Healthy’ BMI, smoking status ‘never’, or no hypertension (absence of hypertension records) were considered as reference values.

Hazard Ratio (HR) values with P < 0.0002 were considered to show significant association with disease onset after correction for multiple-testing using the Bonferroni method

N=154060, Events=218

Factor	Level	Hazard Ratio	P value
BMI	overweight	0.89 (0.65, 1.23)	0.488
BMI	obese	1.16 (0.82, 1.63)	0.404
BMI	underweight	0 (0, Inf)	0.989
smoking	previous	1.75 (1.31, 2.35)	0.000182
smoking	current	2.37 (1.58, 3.55)	3.07e-05
hypertension	yes	1 (0.74, 1.36)	0.997

Definition

UK Biobank field id	Description	Code	Value
20002	Non-cancer illness code, self-reported	1471	atrial fibrillation
20002	Non-cancer illness code, self-reported	1483	atrial flutter
41202	Diagnoses - main ICD10	I48	Atrial fibrillation and flutter
41204	Diagnoses - secondary ICD10	I48	Atrial fibrillation and flutter
40001	Underlying (primary) cause of death: ICD10	I48	Atrial fibrillation and flutter
40002	Contributory (secondary) causes of death: ICD10	I48	Atrial fibrillation and flutter
42040	GP clinical event records	14AN.00	H/O: atrial fibrillation
42040	GP clinical event records	14AR.00	History of atrial flutter
42040	GP clinical event records	212R.00	Atrial fibrillation resolved
42040	GP clinical event records	662S.00	Atrial fibrillation monitoring
42040	GP clinical event records	6A9..00	Atrial fibrillation annual review
42040	GP clinical event records	9Os..00	Atrial fibrillation monitoring administration
42040	GP clinical event records	9Os0.00	Atrial fibrillation monitoring first letter
42040	GP clinical event records	9Os1.00	Atrial fibrillation monitoring second letter
42040	GP clinical event records	9Os2.00	Atrial fibrillation monitoring third letter
42040	GP clinical event records	9Os3.00	Atrial fibrillation monitoring verbal invite
42040	GP clinical event records	9Os4.00	Atrial fibrillation monitoring telephone invite
42040	GP clinical event records	9hF..00	Exception reporting: atrial fibrillation quality indicators
42040	GP clinical event records	9hF1.00	Excepted from atrial fibrillation qual indic: Inform dissent
42040	GP clinical event records	G573200	Paroxysmal atrial fibrillation
42040	GP clinical event records	G573400	Permanent atrial fibrillation
42040	GP clinical event records	G573500	Persistent atrial fibrillation
42040	GP clinical event records	3272.00	ECG: atrial fibrillation
42040	GP clinical event records	G573000	Atrial fibrillation
42040	GP clinical event records	G573300	Non-rheumatic atrial fibrillation
42040	GP clinical event records	G573.00	Atrial fibrillation and flutter
42040	GP clinical event records	G573z00	Atrial fibrillation and flutter NOS
42040	GP clinical event records	3273.00	ECG: atrial flutter
42040	GP clinical event records	G573100	Atrial flutter
42040	GP clinical event records	XaMGD	Atrial fibrillation annual review
42040	GP clinical event records	XaOft	Permanent atrial fibrillation
42040	GP clinical event records	X202S	Non-rheumatic atrial fibrillation
42040	GP clinical event records	XaMDI	Atrial fibrillation monitoring third letter
42040	GP clinical event records	XaNRA	History of atrial flutter
42040	GP clinical event records	XaMFn	Atrial fibrillation monitoring telephone invite
42040	GP clinical event records	XaDv6	H/O: atrial fibrillation
42040	GP clinical event records	XaOfa	Persistent atrial fibrillation
42040	GP clinical event records	XaMDH	Atrial fibrillation monitoring second letter
42040	GP clinical event records	XaLFj	Excepted from atrial fibrillation quality indicators: Informed dissent
42040	GP clinical event records	XaMDG	Atrial fibrillation monitoring first letter
42040	GP clinical event records	XaIIT	Atrial fibrillation monitoring
42040	GP clinical event records	XaLFz	Atrial fibrillation resolved
42040	GP clinical event records	Xa2E8	Paroxysmal atrial fibrillation
42040	GP clinical event records	XaMDK	Atrial fibrillation monitoring verbal invite
42040	GP clinical event records	XaMDF	Atrial fibrillation monitoring administration
42040	GP clinical event records	XaLFh	Exception reporting: atrial fibrillation quality indicators