Introduction. Atrial Fibrillation and Atrial Flutter (AF/AFL), the most
common atrial arrhythmias, have never been examined in combat
casualties. In this study, we investigated the impact of traumatic
injury on AF/AFL among service members with deployment history. Methods.
Sampled from the Department of Defense (DoD) Trauma Registry (n=10,000),
each injured patient in this retrospective cohort study was matched with
a non-injured service member drawn from the Veterans Affairs/DoD
Identity Repository. The primary outcome was AF/AFL diagnosis identified
using ICD-9-CM and ICD-10-CM codes. Competing risk regressions based on
Fine and Gray subdistribution hazards model with were utilized to assess
the association between injury and AF/AFL. Results. There were 130
reported AF/AFL cases, 90 of whom were injured and 40 were non-injured.
The estimated cumulative incidence rates of AF/AFL for injured was
higher compared to non-injured patients (HR = 2.04; 95% CI = 1.44,
2.87). After adjustment demographics and tobacco use, the association
did not appreciably decrease (HR = 1.90; 95% CI = 1.23, 2.93).
Additional adjustment for obesity, hypertension, diabetes, and vascular
disorders, the association between injury and AF/AFL was no longer
statistically significant (HR: 1.51; 95% CI = 0.99, 2.52). Conclusion.
Higher AF/AFL incidence rate was observed among deployed service members
with combat injury compared to servicemembers without injury. The
association did not remain significant after adjustment for
cardiovascular-related covariates. These findings highlight the need for
combat casualties surveillance to further understand the AF/AFL risk
within the military population and to elucidate the potential underlying