Key result
In patients with lone atrial fibrillation, an indexed left atrial volume ≥32 mL/m2 predicted significantly worse event-free survival (adjusted HR 4.46; 95% CI 1.56-12.74; P=0.005).
Why the study?
Does increased left atrial volume predict adverse cardiovascular events in patients originally diagnosed with lone atrial fibrillation?
Cohort (n=46)
Blinded
No
Does increased left atrial volume predict adverse cardiovascular events in patients originally diagnosed with lone atrial fibrillation?
Answers are grounded in this paper and cite their sources.
In patients with lone atrial fibrillation, an indexed left atrial volume ≥32 mL/m² is a strong predictor of long-term adverse cardiovascular events.
AIMS: The objectives of this study were to determine the long-term outcome and the predictors of adverse events in patients originally diagnosed with lone atrial fibrillation (AF). METHODS AND RESULTS: This population-based historical cohort study comprised 46 residents of Olmsted County, MN, USA, with well-documented, clinically defined lone AF and a complete two-dimensional echocardiographic examination. The original echocardiographic videotape recordings were analysed in a blinded fashion for left atrial volume (LAV) and left ventricular ejection fraction. With 1296 person-years of follow-up, the median duration of AF was 27 (first quartile=24, third quartile=33) years. Twenty-three (50%) patients developed events. Cerebral infarction occurred in seven patients, myocardial infarction in 11, and congestive heart failure in 16. In a multivariable analysis, patients with indexed LAV >or=32 mL/m(2) had a significantly worse event-free survival (adjusted HR, 4.46; 95% CI, 1.56-12.74; P=0.005). All cerebral infarctions occurred in patients with an indexed LAV >32 mL/m(2). CONCLUSION: Patients originally diagnosed with benign lone AF follow divergent courses based on LAV. Those originally diagnosed with lone AF and normal sized atria had a benign clinical course throughout the long-term follow-up. Patients with increased LAV at diagnosis or later during the follow-up experienced adverse events.
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Osranek et al. (2005) conducted a cohort in Lone atrial fibrillation (n=46). Indexed left atrial volume ≥32 mL/m2 vs. Indexed left atrial volume <32 mL/m2 was evaluated on Event-free survival (adjusted HR 4.46, 95% CI 1.56-12.74, p=0.005). In patients with lone atrial fibrillation, an indexed left atrial volume ≥32 mL/m2 predicted significantly worse event-free survival (adjusted HR 4.46; 95% CI 1.56-12.74; P=0.005).
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