Clinical Differences between Subtypes of Atrial Fibrillation and Flutter: Cross-Sectional Registry of 407 Patients

Abstract

IntroductionAtrial fibrillation and atrial flutter account for one third of hospitalizations due to arrhythmias, determining great social and economic impacts. In Brazil, data on hospital care of these patients is scarce.ObjectiveTo investigate the arrhythmia subtype of atrial fibrillation and flutter patients in the emergency setting and compare the clinical profile, thromboembolic risk and anticoagulants use.MethodsCross-sectional retrospective study, with data collection from medical records of every patient treated for atrial fibrillation and flutter in the emergency department of Instituto de Cardiologia do Rio Grande do Sul during the first trimester of 2012.ResultsWe included 407 patients (356 had atrial fibrillation and 51 had flutter). Patients with paroxysmal atrial fibrillation were in average 5 years younger than those with persistent atrial fibrillation. Compared to paroxysmal atrial fibrillation patients, those with persistent atrial fibrillation and flutter had larger atrial diameter (48.6 ± 7.2 vs. 47.2 ± 6.2 vs. 42.3 ± 6.4; p < 0.01) and lower left ventricular ejection fraction (66.8 ± 11 vs. 53.9 ± 17 vs. 57.4 ± 16; p < 0.01). The prevalence of stroke and heart failure was higher in persistent atrial fibrillation and flutter patients. Those with paroxysmal atrial fibrillation and flutter had higher prevalence of CHADS2 score of zero when compared to those with persistent atrial fibrillation (27.8% vs. 18% vs. 4.9%; p < 0.01). The prevalence of anticoagulation in patients with CHA2DS2-Vasc ≤ 2 was 40%.ConclusionsThe population in our registry was similar in its comorbidities and demographic profile to those of North American and European registries. Despite the high thromboembolic risk, the use of anticoagulants was low, revealing difficulties for incorporating guideline recommendations. Public health strategies should be adopted in order to improve these rates.

Heart failure and atrial flutter: a systematic review of current knowledge and practices

“…From these, 14 studies described the management separately for AF and AFL patients, of which 5 described electrical cardioversion, 10 catheter ablation, 8 , 22 , 40 , 41 , 42 , 43 , 44 , 45 , 61 , 68 and 9 drug therapy. 8 , 21 , 24 , 41 , 42 , 65 , 68 , 69 …”

Estatística Cardiovascular – Brasil 2020

“…• Em um estudo retrospectivo, dados de 407 pacientes tratados para FA na emergência da cardiologia no primeiro trimestre de 2012 revelaram que as prevalências de insuficiência cardíaca e de AVC foram maiores em pacientes com FA persistente (n=188) e flutter (n=51) do que naqueles com FA paroxística (n=168) (insuficiência cardíaca: 51,2% vs. 45,1% vs. 19,7%; p < 0,01; e AVC: 10,7% vs. 9,8% vs. 1,6%; p < 0,01). 258 Influência dos Fatores de Risco em Fibrilação Atrial e Flutter • Um estudo transversal comparando indivíduos com FA a controles saudáveis encontrou maior frequência de apneia do sono no grupo de FA em comparação ao grupo controle (81,6% vs. 60%, p = 0,03). 259…”

Current Atrial Fibrillation Ablation: An Alert for the Prevention and Treatment of Esophageal Lesions

“…Therefore, a large number of patients still live with the limitations imposed by AF, including decreased quality of life due to symptoms such as palpitations, reduced functional capacity, or manifestations of cardiac insufficiency, in addition to the psychological problems proper of these conditions. 5 , 6 …”