Baseline characteristics of patients with atrial fibrillation: The AFFIRM Study

Ae, Epstein; Slabaugh, Jessica L.; Barnard, Denise H.; Hammitt, Laura L.; Aj, Kaplan; Allen, Byron J.; Lui, Charles Y.; L, Aguirre; Koshkarian, GM; Spiegler, Kevin M.; Goldman, Steven; Ohm, Janet; Greer, G. Stephen; Daly, John; Jk, Bissett; Cotter, Bruno; Dennish, GW; Jones, Claudia; Pai, Sudha M.; Bishop, Vernon S.; Browning, Robert; Kotlewski, Adam; Haywood, L. Julian; Pruitt, Christopher M.; Warner, Alberta; Machuca, K; Behboodikhah, Mahnaz; Delano, S; Brodsky, M; Ahmadi-Kashani, Mastaneh; Rubin, A S; Fattoruso, L; O’Neill, Gearoid; Skadsen, Anne; Linz, Peter; Kozlowski, J; Feld, G.; Tone, LM; Rapoport, Eliot; Ca, Somelofski; Havranek, EP; Smith, Ian; Ramsay, LE; Vanzetta, AM; Hamilton, S; Kirmser, R; Williams, David; Mbonu, ID; Gooray, D; Shetty, Rahul; Knowlan, N; Solomon, A.J.; Sw, Lee; Verrier, Pierre; Ev, Platia; Sinks, J; Rm, Luceri; Rubin, Steven; Curtis, A.B.; Martinez, Sara C.; Seals, A. Allen; Hartley, Jesse; Safford, R E; Baker, Vickie S.; Dinerman, JL; Duncan, Stephen T.; Keim, Samuel M.; Johnson, Tracey; Zebede, Joseph; Garcés, M. Hervella; Sheppard, R. C.; Floden, Lysbeth; Shahawy, Mahfouz El; Tamasovich, D; Applebaum, H. I.; Stagi-Coyle, G; Zoble, RG; Garrett, Donald; Bugni, William J.; Sweeney, Shawn M.; Fg, Smith; Picardi, K; Ahmed, Raheel; Miller, Kim L.; Rees, KA; Yaun, P; Smitheram, T; Writer, SL; Wang, T; Casey, Susan A.; Volgman, AS; Whirry, J; Dj, Wilber; Sexton, B; Swiryn, S.; Giannini, Margherita; O’Toole, Michael; Parness, B; Olshansky, Brian; Hockenberry, Brandon J; Pham, TQ; Burritt, T; Kocheril, AG; Prasun, Marilyn A.; Gest, Caroline; Pinkston, J; Atherton, Clifford W.; Kaufman, Seth; Olgin, Jeffrey E.; Straka, Susan; Jackson, Joseph; Schutzman, John J.; Bormann, Nicholas L.; Rardon, DP; Denny, D. Marty; McCartney, Theresa; Bear, PA; Craig, MB; Beadle, D; Martins, J L; Burke, P; Kuo, Chin-En; Payne, Victoria M.; Decker, Koen De; Singer, Igor; Williamson, Craig A.; Martin, Timothy J.; Yurow, GA; Abi‐Samra, Freddy; Davison, Nancy; Butler, Miriam; Prior, MI; Reddy, Preetham; Smith, SidneyC.; Labadie, Céline; Rj, Weiss; Berg, Claire M.; Cutler, JE; De, Bush; Kern, Leslie S.; Scott, Helge; Bryant, F. C.; Pelini, Michael; Guarnieri, Thomas; Yaker, E; D, Mateski; Maisel, WH; Shea, J.S.; Martin, D. T.; Gs, Woodhead; Cook, JR; Duquette, Mark; Katcher, Michael S.; Meißner,; Qureshi, Tabarak; Richer-Cornish, Karen; Kerin, Nicholas Z.; Quiñones, Luis E.; Chickering, Jennifer; Levanovich, Peter; Frumin, Howard; Terrill, Cynthia J.; Czajka, Magdalena; Duvernoy, WC; Feiro, B; Ce, Heltne; Antolick, A.; Simonson, JS; Larkin, Marilynn; Taylor, Richard D.; Almquist, Adrian K.; Johanson, W. G.; Johnson, J. Cale; Gornick, CC; Haugland, J. Mark; Slivken, R; Packer, D.; Monahan, Kevin M.; Belew, Kathy; Owens, Sonal T.; Rush, Barret; Wittry, S; Osborn, JL; Smith, J.G.; Orosco, C; Turk, Kyong; Carlson, Cathrine R.; Gerling, Barbara R.; Derosa, K; Faillace, R.T.; Tr, Engel; Niblack, PA; Horvitz, LL; Wilson-Castellanos, R; Dwyer, Edward M.; Rosenberg, Frances; Cosgrove, Nora M.; Preminger, MW; Saksena, Sanjeev; Sroczynski, H; Irmiere, C; Tullo, NG; Fieldsend, V; Landzberg, Joel S.; Goldsmith, Ira; Lee, R; Rj, Capone; Sacco, Joseph; Tschinkel, MB; Heller, EN; Valeria, A; Shirani, Jamshid; Kim, Seong‐Gon; Durkin, John; El-Sherif, N; Graham, Sophie; Hollander, Gerald; Budzilowicz, L; Turitto, Gioia; Pang, Kunjing; Lader, Ellis; Constantinou, BB; Ibrahim, BB; Quan, Weilun; Cooper, Joshua M.; Estilo, M; Varriale, Philip; Saravi, G; Coromilas, James; Hickey, Kathleen T.; Vanderbush, E.J.; Abe, Oluwole; Gomes, João R.; Pe, Elena; Slater, William; Guerra, Bolívar; Steinberg, J. S.; Alburo, A; Ta, Rocco; Dwyer, Christopher Michael; Daubert, J; O'Gorman, Edward Niall Stephen; Bloomfield, D; DeStefano, M; Bekheit, S; Schulhoff, Nancy; Allen, Sheila; Maddox, W.K.; Pritchett, Elc; McCarthy, EA; Hoffman, Stanley; Morris, Kathleen; Brewer, Danielle; Hj, Deantonio

doi:10.1067/mhj.2002.122875

Cited by 146 publications

(30 citation statements)

References 30 publications

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“…History of CAD and statin therapy has also been identified as independent predictors for late AA. These results were consistent with previous literature, which demonstrated an association between AF and CAD; 19, 20 however, the impact of preoperative statin use on new-onset AF after non-cardiac surgery remains unsettled. 21 In term of prognosis related to late AA, we did not detect the difference in survival between those with and without late AA.…”

Section: Discussionsupporting

confidence: 92%

Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias After Lung Transplantation

Chaikriangkrai

Jyothula

Jhun

et al. 2015

JACC: Clinical Electrophysiology

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Objective To investigate incidence and timing, risk factors, prognostic significance, and electrophysiological mechanisms of atrial arrhythmia (AA) after lung transplantation. Background Although new-onset AA is common after thoracic surgery and is associated with poorer outcomes, prognostic and mechanistic data is sparse in lung transplant populations. Method A total of 293 consecutive isolated lung transplant recipients without known AA were retrospectively reviewed. Mean follow-up was 28±17 months. Electrophysiology studies (EPS) were performed in 25 patients with AA. Results The highest incidence of new-onset AA after lung transplantation occurred within 30 days postoperative AA, (25 % of all patients). In multivariable analysis, postoperative AA was associated with double lung transplantation (OR 2.79; p=0.005) and lower mean pulmonary artery pressure (OR 0.95; p=0.027). Patients with postoperative AA had longer hospital stays (21 days vs 12 days; p<0.001). Postoperative AA was independently associated with late AA (HR 13.52; p<0.001) but not mortality (HR 1.55; p=0.14). In EPS, there were 14 patients with atrial flutter alone and 11 with atrial flutter and fibrillation. Of all EPS patients, 20 (80%) had multiple AA mechanisms, including peritricuspid flutter (48%), perimitral flutter (36%), right atrial incisional reentry (24%), focal tachycardia from recipient pulmonary vein (PV) antrum (32 %), focal PV fibrillation (24%), and left atrial roof flutter (20%). Left atrial mechanisms were present in 80% (20/25) of EPS patients and originated from the anastomotic PV antrum. Conclusions Postoperative AA was independently associated with longer length of stay and late AA but not mortality. Pleomorphic PV antral arrhythmogenesis from native PV antrum is the main cause of AA after lung transplantation.

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Section: Discussionsupporting

confidence: 92%

Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias After Lung Transplantation

Chaikriangkrai

Jyothula

Jhun

et al. 2015

JACC: Clinical Electrophysiology

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“…The relation between coronary ischemia and AF is well established 8)9). Patients with higher SYNTAX score are known to have more severe coronary ischemia, and also increased short- and long-term adverse events following revascularization.…”

Section: Discussionmentioning

confidence: 99%

“…Standard two-dimensional and color flow Doppler views were acquired according to the guidelines of American Society of Echocardiography and European Society of Echocardiography 8). The ejection fraction was measured according to Simpson's method.…”

Section: Methodsmentioning

confidence: 99%

Is SYNTAX Score Predictive of Atrial Fibrillation after On-Pump Coronary Artery Bypass Graft Surgery?

et al. 2016

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Background and ObjectivesThe relationship of synergy between percutaneous coronary intervention with taxus and cardiac surgery (SYNTAX) score and development of atrial fibrillation (AF) after coronary artery bypass surgery (CABG) has not been studied. Therefore, we assessed the relationship between the SYNTAX score and development of AF after CABG (POAF).Subjects and MethodsThe medical records of consecutive patients, who underwent CABG surgery from January 2013 to September 2015, were retrospectively reviewed for the development of AF in the postoperative period. SYNTAX score, clinical and echocardiographic parameters were evaluated. The independent variables for the development of POAF were defined and their predictive values were measured.ResultsThe study group consisted of 106 patients, of which 36 (34%) developed POAF. Age, hypertension, stroke, chronic obstructive pulmonary disease (COPD), heart failure (HF), diabetes mellitus (DM), left atrial diameter, neutrophil/lymphocyte ratio, platelet large cell ratio, creatinine, blood urea nitrogen and SYNTAX score were identified as important variables for the development of POAF. However, in logistic regression analysis COPD (OR=19.313, 95% CI=2.416-154.407, p=0.005), HF (OR=28.362, 95% CI=2.034-395.515, p=0.013), SYNTAX score (OR=0.863, 95% CI=0.757-0.983, p=0.026), and DM (OR=20.770, 95% CI=3.791-113.799, p<0.001) appeared as independent variables predicting the development of POAF. In receiver operation characteristic analysis, SYNTAX score (≥22.25) (AUC=0.777, 95% CI=0.676-0.877, p<0.001) was one of the strongest predictors for the development of POAF.ConclusionThe SYNTAX score level was independently associated with the development of AF after CABG.

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“…The design and results of the AFFIRM trial have been previously reported. 1,6-9 Briefly, 4060 patients 65–80 years of age with paroxysmal and persistent atrial fibrillation were randomized to receive rate-control (n=2027) versus rhythm-control (n=2033) strategies. To be eligible, patients <65 years of age had to have one of the following risk factors for stroke or death: hypertension, diabetes, heart failure, previous stroke, previous transient ischemic attack, systemic embolism, left atrial enlargement by echocardiography, or reduced left ventricular ejection fraction.…”

Section: Methodsmentioning

confidence: 99%

Rate-control versus Rhythm-control Strategies and Outcomes in Septuagenarians with Atrial Fibrillation

Shariff

Desai

Patel

et al. 2013

The American Journal of Medicine

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Background The prevalence of atrial fibrillation substantially increases after 70 years of age. However, the effect of rate-control versus rhythm-control strategies on outcomes in these patients remains unclear. Methods In the randomized Atrial Fibrillation Follow-up Investigation of Rhythm Management (AFFIRM) trial, 4060 patients (mean age, 70, range, 49–80 years) with paroxysmal and persistent atrial fibrillation were randomized to rate-control versus rhythm-control strategies. Of these, 2248 were 70–80 years, of whom 1118 were in the rate-control group. Propensity scores for rate-control strategy were estimated for each of the 2248 patients and were used to assemble a cohort of 937 pairs of patients receiving rate-control versus rhythm-control strategies, balanced on 45 baseline characteristics. Results Matched patients had a mean age of 75 years, 45% were women, 7% were non-white, and 47% had prior hospitalizations due to arrhythmias. During 3.4 years of mean follow-up, all-cause mortality occurred in 18% and 23% of matched patients in the rate-control and rhythm-control groups, respectively (hazard ratio {HR} associated with rate-control, 0.77; 95% confidence interval {CI}, 0.63–0.94; p=0.010). HRs (95% CIs) for cardiovascular and non-cardiovascular mortality associated with rate-control were 0.88 (0.65–1.18) and 0.62 (0.46–0.84), respectively. All-cause hospitalization occurred in 61% and 68% of rate-control and rhythm-control patients, respectively (HR, 0.76; 95% CI, 0.68–0.86). HRs (95% CIs) for cardiovascular and non-cardiovascular hospitalization were 0.66 (0.56–0.77) and 1.07 (0.91–1.27). Conclusion In septuagenarian patients with atrial fibrillation, compared with rhythm-control, a rate-control strategy was associated with significantly lower mortality and hospitalization.

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Baseline characteristics of patients with atrial fibrillation: The AFFIRM Study

Cited by 146 publications

References 30 publications

Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias After Lung Transplantation

Incidence, Risk Factors, Prognosis, and Electrophysiological Mechanisms of Atrial Arrhythmias After Lung Transplantation

Is SYNTAX Score Predictive of Atrial Fibrillation after On-Pump Coronary Artery Bypass Graft Surgery?

Rate-control versus Rhythm-control Strategies and Outcomes in Septuagenarians with Atrial Fibrillation

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