In patients with first-detected atrial fibrillation without structural heart disease, those presenting with the most severe symptoms have a significantly worse prognosis, including higher mortality and heart failure hospitalization rates.
Severe symptoms may flag higher-risk new AF; hypothesis-generating for targeted strategies pending prospective validation.
BACKGROUND: The characteristics and prognosis of patients with first-detected atrial fibrillation (AF) in Japan remain unclear. METHODS AND RESULTS: First-detected AF patients without structural heart disease (n=289) were reviewed with regard to 2 symptom classifications (CCS-SAF and EHRA). In both classifications, asymptomatic patients comprised ≈40% of the patients, and patients in the most symptomatic class (≈6%) had peculiar characteristics and poor prognosis. In other symptomatic classes, symptoms affected the treatment strategy without a significant difference in the patients' backgrounds and prognosis. CONCLUSIONS: This is the first report to describe the distribution, characteristics and outcomes of first-detected AF patients according to symptom classifications.
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Senoo et al. (2012) studied this question.
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