Heart failure rose in US deaths linked to atrial fibrillation
An observational analysis of 3,273,015 US death certificates from 1999–2023 also found rising dementia-related mortality among adults aged 85 or older.
Journal of Cardiovascular Electrophysiology
Researchers conducted a retrospective observational study of US death certificates for people aged 35 or older with atrial fibrillation, an irregular heartbeat, listed as a contributing cause. They examined records from 1999 to 2023. Among 3,273,015 deaths with atrial fibrillation noted, 461,321 also listed heart failure, dementia, stroke or heart attack as a contributing cause.
Heart failure, when the heart cannot pump blood effectively, became the leading cause or contributor among these conditions. Heart failure-related mortality rose steeply from around 2008. Stroke rates were stable or declining, while heart attack-related mortality stayed low and stable. Dementia-related mortality rose in adults aged 85 or older, particularly dementia without stroke.
Why it matters
As the US population ages, the authors called for atrial fibrillation care to address heart failure prevention and management and cognitive health, alongside stroke prevention.
Caveats
Death-certificate records cannot establish whether atrial fibrillation caused these deaths or why the patterns changed. The findings concern US deaths, not outcomes in everyone living with atrial fibrillation.
The paper
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Arthur Chen, Marc C Engels, Klitos Konstantinidis, Immo Lehmann, Jose Roberto Martinez-Parachini, Douglas L Packer, Ravi Ranjan, Benjamin A Steinberg,University of Utah School of Medicine
Journal of Cardiovascular Electrophysiology · 7 Oct 2026
