Atrial fibrillation reduced 5-year survival compared to sinus rhythm (56% vs 72%, p<0.0001), but this mortality risk diminished with worsening LV function and was absent in severe LV dysfunction.
Cohort (n=8,931)
No
Does atrial fibrillation reduce survival in patients undergoing echocardiography across different LVEF strata?
The prognostic impact of atrial fibrillation on mortality is significant in patients with normal or mildly reduced LVEF, but diminishes and is absent in those with severe LV dysfunction.
Absolute Event Rate: 56% vs 72%
p-value: p=< 0.0001
BACKGROUND: Atrial fibrillation (AF) has been reported to be associated with decreased survival in population-based studies. Its prognostic importance in end-stage heart failure is not clear. METHODS AND RESULTS: We investigated the prognostic implications of AF as function of left ventricular (LV) ejection fraction (EF) in 8,931 consecutive patients undergoing echocardiography at our medical center between 1990 and 1999. Patient characteristics were: age 66 +/- 13 years, EF 51 +/- 15, AF in 1,203 patients. There were 1,911 deaths over a mean follow up of 913 days. The prevalence of AF was 11% in patients with normal left ventricular ejection fraction (LVEF) (EF >/= 55%, n = 5, 130), and 18% each in those with mild (EF 41-54%, n = 1209), moderate (EF 26-40%, n = 1183) and severe reductions in left ventricular ejection fraction (LVEF) (EF /= 450, raising a possibility of enhanced susceptibility of these patients. CONCLUSIONS: The effect of AF on mortality diminishes with worsening LV function and is absent in those with severe LV dysfunction. Susceptibility of patients with QT prolongation to AF mortality warrants further attention.
Pai et al. (Sun,) conducted a cohort in Atrial fibrillation (n=8,931). Atrial fibrillation vs. Sinus rhythm was evaluated on 5-year survival rate (p=< 0.0001). Atrial fibrillation reduced 5-year survival compared to sinus rhythm (56% vs 72%, p<0.0001), but this mortality risk diminished with worsening LV function and was absent in severe LV dysfunction.
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