Chronic atrial fibrillation— epidemiologic features and 14 year follow-up: A case control study

Önundarson, Páll T.; Thorgeirsson, G.; Jonmundsson, E.; Sigfússon, Nikulás; Harðarson, Þórður

doi:10.1093/oxfordjournals.eurheartj.a062312

Cited by 165 publications

(61 citation statements)

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“…2 Patients with heart failure have a five to ten-fold greater probability of developing this arrhythmia than those without heart failure. [3][4][5] To what extent the presence and development of this arrhythmia retains a prognostic role in patients with heart failure remains debatable. [6][7][8][9][10][11][12][13] To date, few studies have evaluated the predictive value of new onset AF in heart failure populations; the results of which have been contradictory.…”

Section: Linkedmentioning

confidence: 99%

Impact of Atrial Fibrillation on Outcome of Patients with Idiopathic Dilated Cardiomyopathy: Data from the Heart Muscle Disease Registry of Trieste

Aleksova¹,

Merlo²,

Zecchin³

et al. 2010

Clinical Medicine & Research

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Objective: There is a paucity and inconsistency of data regarding the natural history of patients affected by idiopathic dilated cardiomyopathy (IDCM) and atrial fibrillation (AF). We examined the prognostic implications of AF in a subset of patients with IDCM. Methods:We analyzed the data of 539 patients with IDCM enrolled in the Heart Muscle Disease Registry of Trieste.Results: At baseline, 52 (9.6%) of 539 patients had AF. There was no difference in survival of patients with either AF or sinus rhythm at enrollment (P=.28). During long-term follow-up (90±58 months), AF was detected on ECG/ECG-Holter monitoring in 28 (5.7%) of 487 patients in sinus rhythm at baseline. Predictors of new onset of AF at multivariate analysis were a more dilated left atrium (OR 1.35, 95% CI 1.06-1.72; P=.01) and a lower left ventricle ejection fraction (for 10% decrease, OR 2.41, 95% CI 1.24-4.69, P=.016). Patients developing AF had higher mortality/heart transplantation rate compared to patients who maintained sinus rhythm during follow-up (P<.001). At multivariate analysis, new onset AF (HR 3.67, 95% CI 2.07-6.5; P<.001) in the first three years after diagnosis, but not baseline AF, was found to be independently associated with a worse outcome. Conclusions:Atrial fibrillation is relatively frequent in patients with IDCM. The early development of AF during follow-up, but not its presence at baseline, is associated with poor survival.

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Section: Linkedmentioning

confidence: 99%

Impact of Atrial Fibrillation on Outcome of Patients with Idiopathic Dilated Cardiomyopathy: Data from the Heart Muscle Disease Registry of Trieste

Aleksova¹,

Merlo²,

Zecchin³

et al. 2010

Clinical Medicine & Research

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“…To what extent the reported cases of AF occur concomitantly with hypertension, coronary artery disease, congestive heart failure or rheumatic heart disease is largely unknown. The cardiovascular conditions and risk factors associated with chronic AF have been examined in many studies [2,5,16,17,18] . There are also fewer studies examining the underlying causes of paroxysmal AF [19][20][21] .…”

Section: Symptomatic Paf In Nw Greece 231mentioning

confidence: 99%

An epidemiological study of symptomatic paroxysmal atrial fibrillation in northwest Greece

et al. 1999

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Aim Although atrial fibrillation (AF) is the most commonly sustained arrhythmia, information about its incidence in the general population is sparse. Even more sparse is information on an important variety of AF, paroxysmal AF. The aim of this study is to assess the frequency of new cases of symptomatic paroxysmal AF per year ('incidence') in a general unselected population and to compare other epidemiological features with chronic AF patients. Methods and ResultsOver a 4 year period, we conducted a prospective, population-based survey of cases of AF in a defined geographical area with a known population size stratified for age and sex. Sources of identification were the two hospitals which serve the area and all the primary care settings. Patients with AF of less than 7 days duration were characterized as paroxysmal AF and all others as chronic AF. During the study period we identified 1551 patients with chronic AF (51·7% male, mean age 71 10·4 years and 48·3% females, mean age 73·1 10·8 years) and 443 patients with paroxysmal AF (59·6% male, mean age 59·6 13·3 years and 40·4% female, mean age 65·2 10·1 years). There was no underlying cardiovascular disease in 15·6% and 32·3% of patients with chronic and paroxysmal AF, respectively. The mean annual occurrence of new cases of paroxysmal AF was 6·2/10 000/year, and was higher (P<0·01) for men (7·2/10 000/year) than for women (5·3/ 10 000/year). The frequency of new paroxysmal AF cases rises with age, reaching a peak at 70-79 years and then declines. ConclusionsWe conclude that paroxysmal AF is a relatively common arrhythmia, the occurrence of which increases with age and is more frequent in younger men than in women. Patients with chronic AF are older and more often have underlying heart and other disease than patients with paroxysmal AF.

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“…8 The risk of AF-related stroke was higher in Caucasian populations than in Asians populations (see Figure 1). 4,[9][10][11][12][13][14][15] AF could in fact drive a prothrombotic or hypercoagulable state, by virtue of its fulfilment of Virchow's triad for thrombogenesis (blood stasis, endocardial dysfunction/damage, and abnormal haemostasis). The most important point in determining the strategy of stroke prevention for AF is how to estimate the thromboembolic (TE) risk accurately.…”

mentioning

confidence: 99%

Stroke in Atrial Fibrillation – Long-term Follow-up of Cardiovascular Events

Chao

Chiang

Chen

2013

Arrhythmia &Amp; Electrophysiology Review

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Atrial fibrillation (AF) is the most common sustained arrhythmia in clinical practice, accounting for approximately one-third of hospitalisations for cardiac rhythm disturbances.1 Between 1980 and 2000, the age-adjusted incidence of AF significantly increased from 3.04 to 3.68 per 1,000 person-years in the US. 2 The prevalence of AF was lower among African Americans than among Caucasians, 3 and it also seemed to be lower in the Asian population. 4,5 In a nationwide cohort of 702,502 participants in Taiwan, the AF incidence was around 1.5 per 1,000 person-years. 6 Since a considerable number of AF patients was paroxysmal in nature, the incidence and prevalence of AF could be significantly underestimated.Systemic thromboembolism is the most severe complication of AF. It accounts for about 15-20 % of ischaemic strokes.7 AF-related strokes were associated with a poor prognosis as more than 50 % of the survivors remain with a severe deficit, and recurrence may be as high as 12 % per year. 8 The risk of AF-related stroke was higher in Caucasian populations than in Asians populations (see Figure 1). 4,[9][10][11][12][13][14][15] AF could in fact drive a prothrombotic or hypercoagulable state, by virtue of its fulfilment of Virchow's triad for thrombogenesis (blood stasis, endocardial dysfunction/damage, and abnormal haemostasis). The most important point in determining the strategy of stroke prevention for AF is how to estimate the thromboembolic (TE) risk accurately. The CHADS 2 score is the most commonly used scheme in stroke risk stratifications for AF patients, 17 despite the fact that it classifies a large proportion of patients as being at 'intermediate risk', and several important TE risk factors were omitted in the scoring system. 18 Recently, a newly developed scoring system, CHA 2 DS 2 -VASc score, which extends the CHADS 2 scheme by considering additional stroke risk factors (vascular diseases and female gender) was recommended to be used to guide the antithrombotic therapies for AF patients. 19,20 The CHA 2 DS 2 -VASc score is most useful in identifying truly low-risk patients, and no antithrombotic therapy is necessary for patients with a CHA 2 DS 2 -VASc score of 0. [21][22][23] In the study performed by Taillandier et al., which enrolled a total of 616 AF patients with a CHA 2 DS 2 -VASc score of 0, an OAC was prescribed on an individual basis in 273 patients (44 %), antiplatelet therapy alone in 145 patients (24 %), and no antithrombotic therapy in 198 patients (32 %).22 During a follow-up of 876 ± 1,135 days, 38 patients experienced adverse events (10 stroke/thromboembolism, 19 major bleeding, 17 deaths). Prescription of OACs and/or antiplatelet therapy was not associated with an improved prognosis for stroke/thromboembolism (relative risk: 0.99, 95 % confidence interval: 0.25-3.99, p-value: 0.99), nor improved survival or net clinical benefit (combination of stroke/ thromboembolism, bleeding and death). More recently, a nationwide cohort study in Taiwan further demonstrated that AF males with a CHA 2 ...

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Chronic atrial fibrillation— epidemiologic features and 14 year follow-up: A case control study

Cited by 165 publications

References 0 publications

Impact of Atrial Fibrillation on Outcome of Patients with Idiopathic Dilated Cardiomyopathy: Data from the Heart Muscle Disease Registry of Trieste

Impact of Atrial Fibrillation on Outcome of Patients with Idiopathic Dilated Cardiomyopathy: Data from the Heart Muscle Disease Registry of Trieste

An epidemiological study of symptomatic paroxysmal atrial fibrillation in northwest Greece

Stroke in Atrial Fibrillation – Long-term Follow-up of Cardiovascular Events

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