Key result
Isolated cardiac amyloidosis detected at autopsy was associated with a significantly higher odds of atrial fibrillation compared to patients without amyloidosis (adjusted OR 5.69).
Why the study?
The role of amyloid deposits in patients with atrial fibrillation without valvular heart disease was undefined.
Does the presence of sub-clinical isolated cardiac amyloidosis increase the odds of atrial fibrillation in elderly patients?
Observational (n=1,083)
No
Does the presence of sub-clinical isolated cardiac amyloidosis increase the odds of atrial fibrillation in elderly patients?
Sub-clinical isolated cardiac amyloidosis is present in a notable proportion of elderly patients and is strongly associated with an increased risk of atrial fibrillation, particularly persistent forms.
May support amyloid evaluation in elderly AF; leaves open causality and screening utility in prospective studies.
Amyloid infiltration of the atrium is described in patients with valvular heart disease and is associated with an increased risk for atrial fibrillation(AF) while amyloid deposits in the ventricles is increasingly being diagnosed in patients with HFpEF. The role of amyloid deposits in patients with AF without valvular heart disease, which represents the most common form of AF globally, is undefined. In this study, we sought to assess the prevalence of sub-clinical isolated cardiac amyloidosis (ICA) at autopsy and the odds of AF in these patients. A total of 1083 patients were included in the study and 3.1% of patients were found to have asymptomatic ICA. Patients with ICA were older and had a higher odds of AF independent of age and CHA 2 DS 2 VASc score. Amongst patients with AF, those with ICA were more likely to have persistent forms of AF and had a lower sinus rhythm P-wave amplitude. Further studies are required to further define this entity, identify imaging modalities to aid in antemortem diagnosis of ICA and to establish the optimal management strategies in these patients.
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Krishnappa et al. (2019) conducted an observational in Atrial Fibrillation and Isolated Cardiac Amyloidosis (n=1,083). Isolated cardiac amyloidosis vs. No isolated cardiac amyloidosis was evaluated on Atrial fibrillation (OR 5.69, 95% CI 2.58-12.55, p=<0.001). Isolated cardiac amyloidosis detected at autopsy was associated with a significantly higher odds of atrial fibrillation compared to patients without amyloidosis (adjusted OR 5.69).
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