How does Chronic Atrial Fibrillation Influence Mortality in the Modern Treatment Era?

Sankaranarayanan, Rajiv; Kirkwood, Graham; Visweswariah, Rajaverma; Fox, David J.

doi:10.2174/1573403x10666140902143020

Cited by 46 publications

(42 citation statements)

References 88 publications

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“…[ 2 ] While there are multiple estimates, the yearly incidence in the US is expected to grow, for example, from 1.2 million cases in 2010 to 2.6 million cases in 2030 and upwards of 6–12 million cases by 2050. [ 1 , 3 ] It is associated with increased morbidity and mortality[ 4 ] and diminished quality of life. [ 5 ] AF is associated with structural heart disease, but it may also occur in a structurally normal heart.…”

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confidence: 99%

Atrial Myopathy Underlying Atrial Fibrillation

Rivner

Mitrani

Goldberger

2020

Arrhythmia &Amp; Electrophysiology Review

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While AF most often occurs in the setting of atrial disease, current assessment and treatment of patients with AF does not focus on the extent of the atrial myopathy that serves as the substrate for this arrhythmia. Atrial myopathy, in particular atrial fibrosis, may initiate a vicious cycle in which atrial myopathy leads to AF, which in turn leads to a worsening myopathy. Various techniques, including ECG, plasma biomarkers, electroanatomical voltage mapping, echocardiography, and cardiac MRI, can help to identify and quantify aspects of the atrial myopathy. Current therapies, such as catheter ablation, do not directly address the underlying atrial myopathy. There is emerging research showing that by targeting this myopathy we can help decrease the occurrence and burden of AF.

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confidence: 99%

Atrial Myopathy Underlying Atrial Fibrillation

Rivner

Mitrani

Goldberger

2020

Arrhythmia &Amp; Electrophysiology Review

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“…A prospective study done in the University of Vienna reported that the incidence of cardiac arrhythmias in surgical and medical intensive care units were 15.7% and 19.7 %, respectively [3] . AF is considered one of the most commonly sustained arrhythmias in clinical practice [16] . In the current study, none of the patients admitted into the CCU with AF had any mortality.…”

Section: Discussionmentioning

confidence: 99%

“…Th is outlines the denotative morbidity accompanying AF and therefore explains the consequence of increased duration of stay in the CCU. It also off ers a clarifi cation for any associated mortality, as some studies now show that the mortality risk of AF is more likely attributed to the entailing co-morbidities rather that the conduction abnormality alone [16] . Th e ability to correctly assess patients and stratify them based on the risk for prolonged and complicated hospitalization indubitably guides the expectations of patients, clinicians, administrators and even reimbursement policies [18] .…”

Section: Discussionmentioning

confidence: 99%

Conduction Abnormalities: Types, Associated Factors and their Effect on Clinical Outcomes of Patients Admitted to the Coronary Care Unit at King Abdulaziz University Hospital

Ibrahim¹,

Alghalayini²,

Milyani³

et al. 2019

Saudi J Intern Med

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Background: Since conduction abnormalities represent a major cause of sudden death and cardiovascular complications, with a high incidence of increased length of hospital stay, risk of disabilities and healthcare costs, the aim was to discern the influence of conduction abnormalities at the time of admission on the clinical outcomes of patients admitted at the Coronary Care Unit in King Abdulaziz University Hospital. Method: The study adopted a retrospective-record review, episode-based design for a period of 2 years. All patients with sustained conduction abnormalities at the time of admission that had either self-terminated or required intervention were recruited. Statistical analysis was conducted by SPSS. Results: A total of 1763 admissions occurred during the study period, conduction abnormalities represented 11.5% of all these cases. The most common types were left bundle branch block and atrial fibrillation. Types that were significantly associated with the length of stay were atrial fibrillation (p = 0.045), ventricular tachycardia (p = 0.020), and ventricular fibrillation (p = 0.007) and complete heart block (p = 0.004). Right bundle branch block was the only conduction abnormality that was significantly associated with higher mortality (p = 0.011). Conclusion: Patients with right bundle branch block need close monitoring and optimal care to reduce risks of increased hospital stay and death. Further, it is imperative that attention should be directed in general to all patients admitted to the Coronary Care Unit with any kind of conduction abnormality in order to attempt to reduce their stay.

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“…There is some controversy about whether the excess mortality observed in patients with AF aged 85 is directly due to AF . While some studies suggest that the mortality risk of AF is really due to the associated co‐morbidities and complications such as embolism or heart failure rather than AF itself, some other studies advocate the role of the side effects of the therapeutic strategies used for treating AF (anti‐arrhythmic drugs, bleeding side effects due to anti‐coagulants, etc.)…”

Section: Discussionmentioning

confidence: 99%