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Aggressive approach and outcome in patients presenting atrial fibrillation and hypertension.
MedLine Citation:
PMID:  21985755     Owner:  NLM     Status:  Publisher    
AIM: Aggressive approach in patients presenting atrial fibrillation (AF) and hypertension could result in improving rhythm control and reducing admission. METHODS: Out of 3475 patients presenting AF, those with hypertension (n=1739, 52%) underwent standard (n=591, group 1, years 2004-2005) or aggressive pharmacological and electrical approach (n=1148, group 2, years 2006-2009). Overall, in 1071 patients AF duration was less than 48h. Primary endpoint was rhythm conversion; secondary endpoints were modalities of rhythm conversion and reduction of admissions. RESULTS: At univariate and multivariate analyses, AF lasting less than 48h, absence of comorbidities and younger age were independent predictors of sinus rhythm; conversely, lack of sinus rhythm, older age, AF lasting more than 48h and comorbidities were independent predictors of hospitalization. Overall, 55% of patients achieved sinus rhythm in group 1 versus 62% in group 2 (p=0.018). Interestingly, in patients with AF lasting less than 48h, 89% achieved sinus rhythm, more likely by class 1C than by class III antiarrhythmic drugs (p<0.001). Overall reduction of admission accounts for 60%; 50% of patients need admission in group 1 versus 29% in group 2 (p<0.001). CONCLUSIONS: Aggressive pharmacological and electrical approach in patients presenting AF and hypertension significantly improved rhythm conversion overall up to 62%. Patients with AF lasting less than 48h eventually achieved sinus rhythm up to 89%, mostly by class IC antiarrhythmic drugs. Admissions eventually reduced up to 60%.
Alberto Conti; Erica Canuti; Yuri Mariannini; Maurizio Zanobetti; Francesca Innocenti; Barbara Paladini; Giuseppe Pepe; Luigi Padeletti; Gian Franco Gensini
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-10-8
Journal Detail:
Title:  International journal of cardiology     Volume:  -     ISSN:  1874-1754     ISO Abbreviation:  -     Publication Date:  2011 Oct 
Date Detail:
Created Date:  2011-10-11     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
Copyright © 2011. Published by Elsevier Ireland Ltd.
Emergency Medicine, Department of Medical and Surgical Critical Care, University of Florence and Careggi University Hospital, Florence, Italy.
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