Aspectos epidemiológicos da fibrilação atrial

Abstract

Atrial fibrillation (AF) is the most common cardiac arrhythmia clinically relevant. In this project we studied the disease based on epidemiological characteristics. Articles from 1947 to April of 2013 were reviewed, matching "atrial fibrillation" and "epidemiology", "screening", "mortality", "morbidity", "risk factors" among others in an international database, taking into consideration impact factor and English language. Results are presented as following: Epidemiological Profile, that analyses prevalence and incidence of AF regarding to age, gender, risk factors and etiology; Morbimortality Profile, that investigates the most commonly associated diseases and their multivariate mortality rates; and Hospitalization Profile, that shows hospitalized AF patients' characteristics and length of stay. Thus, it has been shown that: 1. The increase in life expectancy is accompanied by an increase in AF incidence. The prevalence is significantly higher in men and in older people; 2. Cardiovascular diseases are associated conditions that worsen the AF' severity and mortality rates; 3. There was an increase in hospital expenses and in hospitalizations assigned to AF, in spite of a decrease in hospitalizations in general.

Prevalence of Atrial Fibrillation in Pacemaker Patients

“…Atrial fibrillation is the most frequent arrhythmia in clinical practice, and is present in approximately 0.4% of the general population. 6 In patients with dual-chamber pacemakers (DDD), these values are notably higher, although lower than those recorded in populations with a single-chamber device. 7 The prevalence reported in studies referring to the DDD pacemaker ranges between 16% and 55%, depending on the methodology used.…”

“…In the general population with AF, the prevalence is also lower, approximately 19%. 6 Despite the apparent difference between groups, heart failure did not result in a statistically significant predictor by univariate analysis.…”

“…However, if on the one hand women have a lower incidence, it is important to note that the literature describes a greater impact on the quality of life and mortality in this group. 6 This is an unmodifiable characteristic, and the issues involved in triggering arrhythmia are not clear. Hormone replacement is also an object of study for the prevention of this and other cardiovascular events.…”

Fibrilação Atrial Em Pacientes Submetidos À Hemodiálise Contínua

“…FA é a arritmia supraventricular mais comum na prática clínica, ocasionada por uma desordem eletrofisiológica na comunicação entre o nó sinoatrial e os átrios, com focos ectópicos atriais que tentam conduzir o ritmo cardíaco, levando-os à frequência dos batimentos cardíacos irregulares em torno de 350 bpm. Deste modo, os átrios perdem a função de contração e passam a "fibrilar" (6,(8)(9)(10)(11) . Os registros eletrocardiográficos evidenciam ondas f (fibrilatórias) no traçado, variando sua forma e também sua amplitude (9) .…”

“…O uso de anticoagulantes será um dos primeiros medicamentos a serem indicados no tratamento como prevenção ao risco de formação de trombos, principalmente se estiver apresentando a arritmia por ≥ 48h ou por tempo indeterminado (3)(4)(5) . O risco da FA evoluir para um acidente vascular encefálico isquêmico (AVE) aumenta em 5 vezes mais, pelo fato do átrio não contrair de forma efetiva, estagnando o sangue na cavidade atrial e favorecendo a formação de coágulos (4,10) . Doença cardiovascular (DCV), associada à doença renal crônica (DRC), aumenta o risco de óbitos em pacientes dialíticos, cuja mortalidade chega a ser 10 a 20 vezes maior se comparada à população em geral.…”