Document Detail


Prediction of atrial fibrillation in patients with an implantable cardioverter-defibrillator and heart failure.
MedLine Citation:
PMID:  20861134     Owner:  NLM     Status:  In-Process    
Abstract/OtherAbstract:
AIMS: Heart failure and atrial fibrillation (AF) frequently coexist and AF worsens heart failure prognosis. Device-based diagnostics derived from implantable cardioverter-defibrillator (ICD) interrogation provide an accurate method for detecting AF episodes. This study sought to determine clinical and echocardiographic predictors of AF occurrence, including an index of total atrial conduction time derived by tissue Doppler imaging (PA-TDI duration), in patients with heart failure. Moreover, the role of PA-TDI duration on the prediction of AF occurrence in subgroups of patients with and without history of AF was explored.
METHODS AND RESULTS: A cohort of 495 heart failure patients who underwent ICD implantation was studied. Baseline echocardiographic parameters of systolic and diastolic function were evaluated together with clinical parameters. Furthermore, PA-TDI duration was measured. All patients were prospectively followed up after ICD implantation for AF occurrence detected by ICD interrogation. A total of 142 (29%) patients experienced AF over a follow-up period of 16.4 ± 11.2 months. PA-TDI duration was longer in patients with AF occurrence when compared with patients without AF occurrence (154 ± 27 vs. 135 ± 24 ms, P < 0.001). On Cox-multivariable analysis, female gender [hazard ratio = 1.60; 95% confidence intervals (CI) = 1.09-2.35; P = 0.017], history of AF (hazard ratio = 2.22; 95% CI, 1.51-3.27; P < 0.001), and PA-TDI duration (hazard ratio = 1.27; 95% CI, 1.13-1.42; P < 0.001) were independent predictors of AF occurrence. In the subgroups of patients with and without history of AF, PA-TDI duration remained an independent predictor of AF occurrence.
CONCLUSION: PA-TDI duration may be useful to risk-stratify for AF occurrence in heart failure patients with and without a history of AF.
Authors:
Matteo Bertini; C Jan Willem Borleffs; Victoria Delgado; Arnold C T Ng; Sebastiaan R D Piers; Miriam Shanks; M Louisa Antoni; Mauro Biffi; Giuseppe Boriani; Martin J Schalij; Jeroen J Bax; Nico R L Van de Veire
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of heart failure : journal of the Working Group on Heart Failure of the European Society of Cardiology     Volume:  12     ISSN:  1879-0844     ISO Abbreviation:  Eur. J. Heart Fail.     Publication Date:  2010 Oct 
Date Detail:
Created Date:  2010-09-23     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100887595     Medline TA:  Eur J Heart Fail     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  1101-10     Citation Subset:  IM    
Affiliation:
Departments of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands. m.bertini@lumc.nl
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Comment In:
Eur J Heart Fail. 2010 Oct;12(10):1019-20   [PMID:  20861129 ]

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