Heart, stroke and vascular disease: Australian facts

What is atrial fibrillation?

Atrial fibrillation (AF) is a disturbance of the electrical system of the heart, where the heart beats with an abnormal rhythm, and does not pump blood regularly or work as efficiently as it should.

Often, people with AF do not know that they have it, and they do not experience any symptoms. Others may experience an irregular pulse, heart palpitations (‘fluttering’), fatigue, weakness, discomfort, shortness of breath or dizziness.

Common causes of AF include long-term high blood pressure, coronary heart disease and valvular heart disease. For some people, there is no apparent cause.

The risk of developing AF is higher in older people. Other risks include obesity, diabetes, chronic kidney disease, obstructive sleep apnoea, smoking and alcohol consumption above guideline levels. 

AF increases the risk of stroke, and strokes associated with AF are more severe with a risk of death twice that of other stroke causes. An individual’s risk may be even higher if their AF is associated with previous heart disease or with other chronic diseases (NHFA 2016).

How many Australians are living with atrial fibrillation?

Currently, there are no national data sources that report on the total number of Australians living with AF. 

Surveys and studies on sections of the Australian population suggest that AF affects approximately 2.0% of the general population – equivalent to more than 500,000 people in 2020 (AIHW 2020). 

The proportion affected increases with age. An estimated 5.4% of the Australian population aged 55 and over have AF (Ball et al. 2015).

Hospitalisations

Often, AF can be managed through primary care. However, some patients with AF will need admission to hospital for investigation, management, or surgical or therapeutic procedures. 

Atrial fibrillation often occurs alongside other chronic diseases, so both the principal and additional diagnoses of AF should be counted when estimating its contribution to hospitalisations.

There were around 219,000 hospitalisations where AF was recorded as the principal and/or additional diagnosis in 2023–24, at a rate of 811 per 100,000 population. This represents 1.7% of all hospitalisations in Australia. Atrial fibrillation was recorded as the principal diagnosis in 39% (86,100) of these hospitalisations.

In those cases where AF was listed as an additional diagnosis, common principal diagnoses include other cardiovascular diseases (heart failure, stroke, acute myocardial infarction), pneumonia, sepsis, chronic obstructive pulmonary disease and fracture of femur (AIHW 2020).

Age and sex

Where AF was recorded as the principal and/or additional diagnosis, hospitalisation rates:

• were overall 1.6 times as high for males as females, after adjusting for differences in the age structure of the populations. Age-specific rates were higher among males than females in all age groups, but the gap decreased among those aged 85 years and over
• increased with age, with rates highest for males and females aged 85 and over at least 1.6 and 1.9 times as high as those aged 75–84 respectively (Figure 1).

Trends

Between 2000–01 and 2023–24 the age-standardised rate of hospitalisations with a:

• principal diagnosis of AF increased by 44%
• principal and/or additional diagnosis of AF declined by 17%. The decline was slightly higher among females than males (21% and 16% respectively) (Figure 2).

Variation by priority population groups

In 2023–24, age-standardised AF hospitalisation rates were:

• 1.2 times as high for people living in the lowest socioeconomic areas compared with those in the highest socioeconomic areas. The gap was greater among females than males
• 1.4 times as high among those living in Remote and very remote areas compared with those in Major cities.

For information on First Nations people, see First Nations people. Data disaggregated by priority population groups are available in the supplementary data tables.

Deaths

Atrial fibrillation (AF) contributed to 17,200 deaths (9.2% of all deaths) in 2024 (underlying and/or associated cause) – a rate of 63 per 100,000 population.

AF is far more likely to be listed as an associated cause of death. This is because it is often not AF that leads directly to death – rather, one of its accompanying comorbidities or complications will be listed as the underlying cause of death on the death certificate.

When AF is examined as an associated cause of death, the conditions most commonly listed as the underlying cause of death were:

• coronary heart disease (15%)
• dementia including Alzheimer’s disease (8.7%)
• cerebrovascular disease (7.3%).

Age and sex

In 2024, death rates for AF as the underlying or associated cause:

• were 1.3 times as high for males as for females after adjusting for differences in the age structure of the populations. Age-specific rates were higher for males than females across all age groups
• increased with age, with 62% of deaths occurring among those aged 85 and over. AF death rates for males and females in the 85 and over age group were 5.3 and 7.8 times as high as that for males and females aged 75–84, respectively (Figure 3).

Trends

Between 1997 and 2024:

• the number of deaths where AF was an underlying or associated cause increased 4-fold, from 4,400 to 17,200
• age-standardised AF death rates increased by 65% overall, which is in contrast with most cardiovascular disease subtypes (Figure 4).

Variation by priority population groups

In 2024, the age-standardised death rate for AF as an underlying or associated cause was:

• 1.5 times as high for people living in the lowest socioeconomic areas compared with those living in the highest socioeconomic areas
• 1.4 times as high among people living in Remote and very remote areas when compared to those living in Major cities. Males had higher AF death rates than females in all remoteness areas.

For information on First Nations people, see First Nations people. Data disaggregated by priority population groups are available in the supplementary data tables.