Reference : Atrial fibrillation is under-recognized in chronic heart failure: insights from a hea...
Scientific journals : Article
Human health sciences : Cardiovascular & respiratory systems
http://hdl.handle.net/10993/18360
Atrial fibrillation is under-recognized in chronic heart failure: insights from a heart failure cohort treated with cardiac resynchronization therapy.
English
Caldwell, Jane C. [> >]
Contractor, Hussain [> >]
Petkar, Sanjiv [> >]
Ali, Razwan [> >]
Clarke, Bernard [> >]
Garratt, Clifford J. [> >]
Neyses, Ludwig mailto [University of Luxembourg > Research Office]
Mamas, Mamas A. [> >]
2009
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
11
10
1295-300
Yes (verified by ORBilu)
International
1099-5129
1532-2092
England
[en] Aged ; Atrial Fibrillation/diagnosis/epidemiology ; Cardiac Pacing, Artificial/utilization ; Cohort Studies ; Comorbidity ; False Negative Reactions ; Female ; Great Britain/epidemiology ; Heart Failure/diagnosis/epidemiology/prevention & control ; Humans ; Incidence ; Male ; Reproducibility of Results ; Retrospective Studies ; Risk Assessment ; Risk Factors ; Sensitivity and Specificity ; Treatment Outcome
[en] AIMS: Atrial fibrillation (AF) is the most common sustained arrhythmia in patients with chronic heart failure (CHF). Under-detection of asymptomatic paroxysmal AF (PAF) underestimates the true burden of AF in patients with CHF. We retrospectively studied the prevalence of asymptomatic PAF in 162 CHF patients through analysis of cardiac resynchronization therapy (CRT) device downloads to determine whether these episodes are associated with adverse outcomes. METHODS AND RESULTS: An episode of AF was defined by mode switching on CRT devices with an atrial rate >200 for at least 30 s. Of the 101 patients thought to be persistently in sinus rhythm (SR), 27% were found to have significant paroxysms of AF, with the cumulative percentage of time in the 'mode-switch mode' (i.e. the AF burden) of 1.6 +/- 0.9%. Mortality was 19.2% in patients with newly identified PAF with hospitalization and thrombo-embolism rates of 42.3 and 2.1%, respectively, compared with mortality of 10.4% with hospitalization and thrombo-embolism rates of 41.8 and 1.9%, respectively, in patients persistently in SR (P= NS). CONCLUSION: Analysis of data from CRT devices in a population of CHF patients with severe left ventricular dysfunction shows that a significant proportion of those perceived to be persistently in SR have undiagnosed paroxysms of AF but with relatively low burden. These episodes appear to be associated with a trend towards increased mortality but no effects on hospitalization or thrombo-embolism rates.
http://hdl.handle.net/10993/18360
10.1093/europace/eup201
http://europace.oxfordjournals.org/content/11/10/1295.long

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