AIMS: We evaluated the prognostic impact of a first episode of symptomatic atrial fibrillation under real life conditions. BACKGROUND: Most studies regarding the treatment and long-term outcome of patients with atrial fibrillation mainly refer to patients with recurrent episodes. In contrast, data on the prognostic implications of a first episode of atrial fibrillation are scarce. METHODS: Over a follow-up period of 5 years, we analyzed 1053 patients, initially scheduled for cardioversion of symptomatic atrial fibrillation, who were included into the prospective registry ANTIK (Ludwigshafener ANTIKoagulationsstudie). RESULTS: Of those, 618 patients (59%) were included with a first episode of symptomatic atrial fibrillation whereas 435 patients (41%) presented with recurrent episodes. As a consequence of referral for cardioversion of symptomatic atrial fibrillation, structural heart disease was newly diagnosed in a significantly higher proportion of patients with a first episode (27 vs 13%, OR 2.4, 95% CI 1.7-3.3) and patients with a first episode were more likely to have an EF</=40% (21 vs 15%, OR 1.5, 95% CI 1.1-2.2). After 5 years, the mortality rate for patients with a first episode was higher than for those with recurrent episodes (27 vs 16%, OR 2.0, 95% CI 1.4-2.7). In the multivariate analysis, a first episode also was independently associated with an increased longterm mortality (HR 1.4, 95% CI 1.02-1.98). In contrast to patients with recurrent episodes, a first episode was associated with a significantly higher mortality, when compared to an age-matched control group calculated from mortality tables. CONCLUSION: The first episode of symptomatic atrial fibrillation intended for cardioversion serves as a marker for underlying cardiac diseases and is associated with impaired prognosis.
AIMS: We evaluated the prognostic impact of a first episode of symptomatic atrial fibrillation under real life conditions. BACKGROUND: Most studies regarding the treatment and long-term outcome of patients with atrial fibrillation mainly refer to patients with recurrent episodes. In contrast, data on the prognostic implications of a first episode of atrial fibrillation are scarce. METHODS: Over a follow-up period of 5 years, we analyzed 1053 patients, initially scheduled for cardioversion of symptomatic atrial fibrillation, who were included into the prospective registry ANTIK (Ludwigshafener ANTIKoagulationsstudie). RESULTS: Of those, 618 patients (59%) were included with a first episode of symptomatic atrial fibrillation whereas 435 patients (41%) presented with recurrent episodes. As a consequence of referral for cardioversion of symptomatic atrial fibrillation, structural heart disease was newly diagnosed in a significantly higher proportion of patients with a first episode (27 vs 13%, OR 2.4, 95% CI 1.7-3.3) and patients with a first episode were more likely to have an EF</=40% (21 vs 15%, OR 1.5, 95% CI 1.1-2.2). After 5 years, the mortality rate for patients with a first episode was higher than for those with recurrent episodes (27 vs 16%, OR 2.0, 95% CI 1.4-2.7). In the multivariate analysis, a first episode also was independently associated with an increased longterm mortality (HR 1.4, 95% CI 1.02-1.98). In contrast to patients with recurrent episodes, a first episode was associated with a significantly higher mortality, when compared to an age-matched control group calculated from mortality tables. CONCLUSION: The first episode of symptomatic atrial fibrillation intended for cardioversion serves as a marker for underlying cardiac diseases and is associated with impaired prognosis.
Authors: Isabelle C Van Gelder; Vincent E Hagens; Hans A Bosker; J Herre Kingma; Otto Kamp; Tsjerk Kingma; Salah A Said; Julius I Darmanata; Alphons J M Timmermans; Jan G P Tijssen; Harry J G M Crijns Journal: N Engl J Med Date: 2002-12-05 Impact factor: 91.245
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Authors: B M Psaty; T A Manolio; L H Kuller; R A Kronmal; M Cushman; L P Fried; R White; C D Furberg; P M Rautaharju Journal: Circulation Date: 1997-10-07 Impact factor: 29.690
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Authors: Jonathan S Steinberg; Ara Sadaniantz; Jack Kron; Andrew Krahn; D Marty Denny; James Daubert; W Barton Campbell; Edward Havranek; Katherine Murray; Brian Olshansky; Gearoid O'Neill; Magdi Sami; Stanley Schmidt; Randle Storm; Miguel Zabalgoitia; John Miller; Mary Chandler; Elaine M Nasco; H Leon Greene Journal: Circulation Date: 2004-03-29 Impact factor: 29.690
Authors: Fikret Er; Orhan Aslan; Evren Caglayan; Natig Gassanov; Amir M Nia; Erland Erdmann; Stephan Rosenkranz Journal: Clin Res Cardiol Date: 2010-02-24 Impact factor: 5.460