Paroxysmal atrial fibrillation coincident with cardiac decompensation significantly increased the risk of readmission for chronic heart failure exacerbation (RR 2.30).
Cohort (n=427)
No
Does paroxysmal atrial fibrillation coincident with cardiac decompensation predict death or rehospitalization in patients with chronic heart failure?
Paroxysmal atrial fibrillation occurring during acute heart failure decompensation is a strong independent predictor of subsequent heart failure readmission.
Estimación del efecto: RR 2.30 (95% CI 1.30-4.05)
Tasa de eventos absoluta: 64.3% vs 37.2%
valor p: p=0.004
BACKGROUND: The prognostic significance of atrial fibrillation (AF) in chronic heart failure (CHF) remains poorly understood. METHODS AND RESULTS: Death and rehospitalizaion for CHF exacerbation for 427 consecutive patients hospitalized from 1996 to 2002 were retrospectively analyzed in relation to cardiac rhythm: sinus rhythm (SR; n=239) or AF (n=188). The AF group was classified according to an Intervention (n=57) or Non-Intervention (n=131) group for defibrillating AF. During the follow-up of 34+/-23 months, there was no significant difference of mortality or morbidity between the SR and AF groups, or between the Intervention and Non-Intervention groups, respectively. However, the Non-Intervention group consisted of 28 patients with paroxysmal AF (PAF), which spontaneously converted to SR during hospitalization, and 103 with chronic AF (CAF). The rehospitalization for CHF exacerbation was significantly higher in PAF than that in CAF and SR (p=0.00005 and 0.002, respectively). Multivariate Cox analysis demonstrated that, PAF, but not CAF, was a predictor of readmission (relative risk 2.30, p=0.004, 95% confidence interval 1.30 to 4.05). CONCLUSIONS: The present data implied that PAF coincident with cardiac decompensation could be a new predictor of prognosis for CHF. The management strategies of AF in CHF should be discussed according to the phenotype of AF.
Koitabashi et al. (Sat,) conducted a cohort in Chronic Heart Failure (n=427). Paroxysmal Atrial Fibrillation (PAF) vs. Sinus Rhythm (SR) or Chronic Atrial Fibrillation (CAF) was evaluated on Readmission for CHF exacerbation (RR 2.30, 95% CI 1.30-4.05, p=0.004). Paroxysmal atrial fibrillation coincident with cardiac decompensation significantly increased the risk of readmission for chronic heart failure exacerbation (RR 2.30).