Document Detail

Risk factors for systemic embolism in patients with paroxysmal atrial fibrillation.
MedLine Citation:
PMID:  1615799     Owner:  NLM     Status:  MEDLINE    
The purpose of this study was to define the risk factors for systemic embolism in patients with recently diagnosed paroxysmal atrial fibrillation. We therefore studied 63 consecutive patients with symptomatic nonvalvular paroxysmal atrial fibrillation and performed a clinical and noninvasive cardiac, peripheral vascular, and neurologic evaluation that included two-dimensional echocardiography, 24-hour Holter monitoring, and computed tomographic brain scan. Patients with predisposing clinical conditions for systemic embolism (valvular heart or coronary artery disease) or paroxysmal atrial fibrillation (sick sinus disease, preexcitation, or thyroid dysfunction) were excluded. At entry 34 patients had idiopathic paroxysmal atrial fibrillation and 29 had hypertension. Fourteen patients had a recent systemic embolic complication: nine had a recent occlusive nonlacunar cerebrovascular accident, two had transient ischemic attacks, and three had peripheral systemic emboli that required surgery. In addition, five patients had evidence of old cerebrovascular accident on the computed tomographic scan (group 1). Forty-four patients had no systemic embolism (group 2). Results of univariate analysis showed that patients in group 1 were older (72 +/- 9 vs 63 +/- 13 years, p less than 0.05), had a higher incidence of hypertension (70% vs 35%, p less than 0.01), and had an increased left atrial diameter (4.1 +/- 0.7 vs 3.6 +/- 0.5 cm, p less than 0.05). Multiple stepwise logistic regression analysis showed that a history of hypertension and left atrial enlargement on two-dimensional echocardiography were significant independent risk factors for systemic embolism in patients with symptomatic nonvalvular paroxysmal atrial fibrillation.
R Corbalán; D Arriagada; S Braun; J Tapia; I Huete; A Kramer; A Chávez
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American heart journal     Volume:  124     ISSN:  0002-8703     ISO Abbreviation:  Am. Heart J.     Publication Date:  1992 Jul 
Date Detail:
Created Date:  1992-07-30     Completed Date:  1992-07-30     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  149-53     Citation Subset:  AIM; IM    
Pontificia Universidad Católica de Chile, Department of Cardiovascular Diseases, Santiago.
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MeSH Terms
Atrial Fibrillation / complications*,  epidemiology
Electrocardiography, Ambulatory
Hypertension / epidemiology
Intracranial Embolism and Thrombosis / epidemiology*,  etiology
Middle Aged
Prospective Studies
Regression Analysis
Risk Factors
Tomography, X-Ray Computed

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