Document Detail


Long-term prognosis after cardioversion of the first episode of symptomatic atrial fibrillation: a condition believed to be benign revised.
MedLine Citation:
PMID:  17938851     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
Torsten Becker; Thomas Kleemann; Margit Strauss; Klaus Doenges; Steffen Schneider; Jochen Senges; Karlheinz Seidl
Publication Detail:
Type:  Journal Article     Date:  2007-10-19
Journal Detail:
Title:  Clinical research in cardiology : official journal of the German Cardiac Society     Volume:  97     ISSN:  1861-0692     ISO Abbreviation:  Clin Res Cardiol     Publication Date:  2008 Feb 
Date Detail:
Created Date:  2008-02-18     Completed Date:  2009-10-15     Revised Date:  2010-03-23    
Medline Journal Info:
Nlm Unique ID:  101264123     Medline TA:  Clin Res Cardiol     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  74-82     Citation Subset:  IM    
Affiliation:
Klinikum der Stadt Ludwigshafen, Herzzentrum, Bremserstr. 79, 67063, Ludwigshafen, Germany. beckert@klilu.de
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MeSH Terms
Descriptor/Qualifier:
Age Factors
Aged
Atrial Fibrillation / diagnosis*,  mortality,  therapy*
Confidence Intervals
Early Diagnosis
Electric Countershock / methods*
Electrocardiography*
Female
Humans
Kaplan-Meiers Estimate
Male
Middle Aged
Odds Ratio
Prognosis
Prospective Studies
Recurrence
Registries
Risk Assessment
Severity of Illness Index
Sex Factors
Statistics, Nonparametric
Survival Rate
Time Factors
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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