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BackgroundAtrial fibrillation (AF) is the most common arrhythmia, and the incidence increases rapidly all over the world. The global prevalence of AF (age-adjusted) is 0.60% for men and 0.37% for women and the prevalence of AF in China is 0.65%. It is expected that the number of patients with AF will continue to rise in the future worldwide due to population aging.ObjectiveTo explore the prevalence of AF in Chinese community population in 2019 and clarify the prevalence of AF complicated with other arrhythmias and myocardial ischemia (MI) events.MethodsThe remote electrocardiogram (ECG) diagnosis system of Xinhua Hospital was assessed to the screen participants with ECG evidence of AF between January 1 and December 31, 2019. The prevalence rates of AF and its association with other arrhythmias and MI events were analyzed and subgroup analysis was performed between different sexes and age groups.ResultsA total of 22,016 AF cases were identified out of all ECGs derived from the remote ECG diagnosis system in 2019. It is estimated that AF was presented in nearly 10.15 million people in China (age-adjusted standardized rate 0.72%, 95% CI 0.20–1.25%) in 2019 and 62% of the AF cases (6.27 million) affected people aged 65 years and above (age-adjusted standardized rate 3.56%, 95% CI 3.28–3.85%). The prevalence rate of AF in males was higher than that in females (p < 0.001), and the ventricular rate of AF patients was faster in females (p < 0.001) and younger patients (p < 0.001). AF patients with lower ventricular rate (under 60 beats per min) were associated with increased prevalence of ventricular escape/escape rhythm [p < 0.001, odds ratio (OR) 5.14] and third-degree atrioventricular block (p < 0.001, OR 32.05).ConclusionThe prevalence of AF is higher in the Chinese community population than that was previously reported. AF patients complicated with ECG patterns suggesting myocardial infarction is common in men, and stricter measures should be taken to control the common risk factors of AF and coronary heart disease. It is also important that more attention should be paid to recognize fatal arrhythmias, especially in elderly male patients with AF.

BackgroundThe COVID-19 pandemic has led to concerns around its subsequent impact on global health.ObjectiveTo investigate the health-seeking behavior, reflected by ECG utilization patterns, of patients with non-COVID-19 diseases during and after COVID-19 epidemic.MethodsTaking advantage of the remote ECG system covering 278 medical institutions throughout Shanghai, the numbers of medical visits with ECG examinations during the lockdown (between January 23 and April 7, 2020), post-lockdown (between April 8 and December 31, 2020) and post-SARS-CoV-2 (between January 23 and April 7, 2021) periods were analyzed and compared against those during the same periods of the preceding years (2018 and 2019).ResultsCompared with the same period during pre-COVID years, the number of medical visits decreased during the lockdown (a 38% reduction), followed by a rebound post-lockdown (a 17% increase) and a fall to the baseline level in post-SARS-CoV-2 period. The number of new COVID-19 cases announced on a given day significantly correlated negatively with the numbers of medical visits during the following 7 days. Medical visit dynamics differed for various arrhythmias. Whereas medical visits for sinus bradycardia exhibited a typical decrease-rebound-fallback pattern, medical visits for atrial fibrillation did not fall during the lockdown but did exhibit a subsequent increase during the post-lockdown period. By comparison, the volume for ventricular tachycardia remained constant throughout this entire period.ConclusionThe ECG utilization patterns of patients with arrhythmias exhibited a decrease-rebound-fallback pattern following the COVID-19 lockdowns. Medical visits for diseases with more severe symptoms were less influenced by the lockdowns, showing a resilient demand for healthcare.

BACKGROUND Atrial fibrillation is the most common arrhythmia, and the incidence increases rapidly all over the world. The global prevalence of atrial fibrillation (age-adjusted) is 0·60% for men and 0·37% for women. The prevalence situation of atrial fibrillation(age-adjusted) in China is 0·65%, and it is expected that the number of patients with atrial fibrillation will continue to rise in the future worldwide due to population aging. OBJECTIVE To explore the prevalence of atrial fibrillation in Chinese community population in 2019 and clarify the prevalence of atrial fibrillation complicated with other arrhythmias and myocardial ischemia events. METHODS The remote ECG diagnosis system of Xinhua Hospital was assessed to screen participants with ECG evidence of AF from Jan 1, 2019 to Dec 31, 2019. The prevalence rates of atrial fibrillation and its association with other arrhythmias and myocardial ischemia events were analyzed and subgroup analysis was performed between different gender and age groups. RESULTS A total of 22016 AF cases were identified out of all ECGs derived from the remote ECG diagnosis system in 2019. The prevalence rate of atrial fibrillation in the remote ECG diagnosis platform in 2019 was about 2.75%(95%CI 2.71%-2.78%). The prevalence rate of atrial fibrillation in males was higher than that in females (p<0.001), and the ventricular rate was faster in female patients (p<0.001). The prevalence rate of atrial fibrillation in participants aged 65 or above was higher than that in participants under 65 years old (p<0.001) and the ventricular rate was lower in aged group (p<0.001). Atrial fibrillation with lower ventricular rate is associated with increased prevalence of third-degree atrioventricular block (p<0.001). CONCLUSIONS According to these results, it is estimated that the number of patients with atrial fibrillation in China are around 7.98 million in 2019. The analysis of different genders suggests the necessity of the monitoring on ventricular rate in elderly male patients with atrial fibrillation to timely recognize severe arrhythmias.