Key result
Asymptomatic atrial fibrillation was associated with a higher prevalence of coronary artery disease (57.5% vs. 49.1%, p<0.0001) and heart failure compared to symptomatic atrial fibrillation.
Why the study?
Atrial fibrillation can cause severe symptoms but is frequently asymptomatic, and the clinical features distinguishing asymptomatic from symptomatic patients needed comparison.
What are the clinical differences and predictors of asymptomatic versus symptomatic atrial fibrillation in hospitalized patients?
Observational (n=2,785)
Yes
What are the clinical differences and predictors of asymptomatic versus symptomatic atrial fibrillation in hospitalized patients?
Absolute Event Rate: 57.5% vs 49.1%
p-value: p=<0.0001
Hospitalized patients with asymptomatic AF have a higher burden of cardiovascular comorbidities such as coronary artery disease and HFpEF, but present with better left ventricular function compared to symptomatic patients.
Asymptomatic status should not yet alter CAD or HF evaluation in AF; leaves open whether it marks a higher-risk phenotype.
Background: Atrial fibrillation (AF) can cause severe symptoms, but it is frequently asymptomatic. We aimed to compare the clinical features of patients with asymptomatic and symptomatic AF. Methods: A prospective, observational, multicenter study was performed (the Polish Atrial Fibrillation (POL-AF) registry). Consecutive hospitalized AF patients over 18 years of age were enrolled at ten centers. The data were collected for two weeks during each month of 2019. Results: A total of 2785 patients were analyzed, of whom 1360 were asymptomatic (48.8%). Asymptomatic patients were more frequently observed to have coronary artery disease (57.5% vs. 49.1%, p < 0.0001), heart failure with preserved ejection fraction (39.8% vs. 26.5%, p < 0.0001), a previous thromboembolic event (18.2% vs. 13.1%, p = 0.0002), and paroxysmal AF (52.3% vs. 45.2%, p = 0.0002). In multivariate analysis, history of electrical cardioversion, paroxysmal AF, heart failure, coronary artery disease, previous thromboembolic event, and higher left ventricular ejection fraction were predictors of a lack of AF symptoms. First-diagnosed AF was a predictor of AF symptoms. Conclusions: In comparison to symptomatic patients, more of those hospitalized with asymptomatic AF had been previously diagnosed with this arrhythmia and other cardiovascular diseases. However, they presented with better left ventricular function and were more frequently treated with cardiovascular medicines.
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Kiliszek et al. (2021) conducted an observational in Atrial fibrillation (n=2,785). Asymptomatic atrial fibrillation vs. Symptomatic atrial fibrillation was evaluated on Coronary artery disease (p=<0.0001). Asymptomatic atrial fibrillation was associated with a higher prevalence of coronary artery disease (57.5% vs. 49.1%, p<0.0001) and heart failure compared to symptomatic atrial fibrillation.
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