In patients with acute pulmonary embolism, paroxysmal atrial fibrillation was associated with 6.5% in-hospital mortality, similar to sinus rhythm (5%), but lower than permanent AF (25%) (P<0.001).
Observational (n=391)
Does paroxysmal atrial fibrillation impact short-term prognosis and clinical characteristics in patients with acute pulmonary embolism compared to sinus rhythm or permanent AF?
In patients with acute pulmonary embolism, paroxysmal atrial fibrillation is associated with more severe right ventricular afterload impairment but does not significantly increase short-term in-hospital mortality compared to sinus rhythm.
Tasa de eventos absoluta: 6.5% vs 5%
valor p: p=<0.001
The relationship and clinical implications of atrial fibrillation (AF) in acute pulmonary embolism (PE) are poorly investigated. We aimed to analyze clinical characteristics and prognosis in PE patients with paroxysmal AF episode. Methods . From the 391 patients with PE 31 subjects with paroxysmal AF were selected. This group was compared with patients with PE and sinus rhythm (SR) and 32 patients with PE and permanent AF. Results . Paroxysmal AF patients were the oldest. Concomitant DVT varies between groups: paroxysmal AF 32.3%, SR 49.5%, and permanent AF 28.1% (p=0.02). The stroke history frequency was 4.6% SR, 12.9% paroxysmal AF, and 21.9% permanent AF (p0.001). Paroxysmal AF comparing to permanent AF and SR individuals had higher estimated SPAP (56 versus 48 versus 47 mmHg, p=0.01) and shorter ACT (58 versus 65 versus 70 ms, p=0.04). Patients with AF were more often classified into high-risk group according to revised Geneva score and sPESI than SR patients. In-hospital mortality was lower in SR (5%) and paroxysmal AF (6.5%) compared to permanent AF group (25%) (p0.001). Conclusions . Patients with PE-associated paroxysmal AF constitute a separate population. More severe impairment of the parameters reflecting RV afterload may indicate relation between PE severity and paroxysmal AF episode. Paroxysmal AF has no impact on short-term mortality.
Krajewska et al. (Sun,) conducted a observational in Acute pulmonary embolism (n=391). Paroxysmal atrial fibrillation vs. Sinus rhythm and permanent atrial fibrillation was evaluated on In-hospital mortality (p=<0.001). In patients with acute pulmonary embolism, paroxysmal atrial fibrillation was associated with 6.5% in-hospital mortality, similar to sinus rhythm (5%), but lower than permanent AF (25%) (P<0.001).
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