Prognostic significance of present atrial fibrillation on a single office electrocardiogram in patients with atrial fibrillation.

Krisai, P; Hämmerle, P; Blum, S; Meyre, P; Aeschbacher, S; Melchiorre-Mayer, P; Baretella, O; Rodondi, Nicolas; Conen, D; Osswald, S; Kühne, M; Zuern, C S (2021). Prognostic significance of present atrial fibrillation on a single office electrocardiogram in patients with atrial fibrillation. Journal of internal medicine, 289(3), pp. 395-403. Blackwell Scientific Publications 10.1111/joim.13168

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BACKGROUND

Evidence for the association of atrial fibrillation (AF) present on the ECG and cardiovascular outcomes in AF patients is limited.

OBJECTIVE

To investigate the prognostic significance of AF on a single surface ECG for cardiovascular outcomes in AF patients.

METHODS

A total of 3642 AF patients were prospectively enrolled. Main exclusion criteria were rhythms other than sinus rhythm (SR) or AF. The primary end-point was a composite of all-cause death and hospitalizations for congestive heart failure (CHF). Secondary end-points were all-cause death, CHF hospitalizations, cardiovascular death, myocardial infarction, any stroke and stroke subtypes. Associations were assessed with multivariable Cox proportional hazards models.

RESULTS

Mean age was 71 years, 28% were female, and mean follow-up was 3.4 years. Patients with SR on the ECG at study enrolment (56%) were younger (69 vs. 74 years, P < 0.0001), had more often paroxysmal AF (73 vs. 18%, P < 0.0001) and fewer comorbidities. The incidence of the primary end-point was 1.8 and 3.1 per 100 person-years in patients with SR and AF, respectively. The multivariable-adjusted hazard ratio was 1.4 (95% confidence intervals 1.1; 1.7; P = 0.001) for patients with AF on the ECG compared to patients with SR. The hazard ratios (95% confidence intervals) were 1.4 (1.1; 1.8; P = 0.006) for all-cause death, 1.5 (1.2; 1.9; P = 0.001) for CHF and 1.6 (1.1; 2.2; P = 0.006) for cardiovascular death. None of the other associations were statistically significant.

CONCLUSIONS

The presence of AF in a single office ECG had significant prognostic implications with regard to mortality and CHF hospitalizations in patients with AF. These patients present a high-risk group and might benefit from intensified treatment.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)

UniBE Contributor:

Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0954-6820

Publisher:

Blackwell Scientific Publications

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

22 Oct 2020 10:45

Last Modified:

28 Mar 2021 22:56

Publisher DOI:

10.1111/joim.13168

PubMed ID:

32914467

Uncontrolled Keywords:

atrial fibrillation cardiovascular outcomes electrocardiogram sinus rhythm

BORIS DOI:

10.7892/boris.147239

URI:

https://boris.unibe.ch/id/eprint/147239

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