Long-term Prognosis of Paroxysmal Atrial Fibrillation and Predictors for Progression to Persistnt or Chronic Atrial Fibrillation in the Korean Population.
10.3346/jkms.2015.30.7.895
- Author:
Sung II IM
1
;
Kwang Jin CHUN
;
Seung Jung PARK
;
Kyoung Min PARK
;
June Soo KIM
;
Young Keun ON
Author Information
1. Division of Cardiology, Kosin University Gospel Hospital, Kosin University College of Medicine, Busan, Korea.
- Publication Type:Original Article
- Keywords:
Paroxysmal Atrial Fibrillation;
Progression;
Korean Populations
- MeSH:
Aged;
Atrial Fibrillation/epidemiology/mortality/*pathology;
Atrial Flutter/*epidemiology/mortality/pathology;
Atrial Premature Complexes/*epidemiology/mortality/pathology;
Disease Progression;
Echocardiography;
Female;
Heart Atria/pathology/ultrasonography;
Humans;
Male;
Middle Aged;
Republic of Korea/epidemiology;
Retrospective Studies;
Tachycardia, Ectopic Atrial/*epidemiology/mortality/pathology;
Tachycardia, Paroxysmal/*epidemiology/mortality/pathology;
Thromboembolism/epidemiology/mortality;
Treatment Outcome
- From:Journal of Korean Medical Science
2015;30(7):895-902
- CountryRepublic of Korea
- Language:English
-
Abstract:
Little is known about the long-term prognosis of or predictors for the different clinical types of atrial fibrillation (AF) in Korean populations. The aim of this study was to validate a risk stratification to assess the probability of AF progression from paroxysmal AF (PAF) to persistent AF (PeAF) or permanent AF. A total of 434 patients with PAF were consecutively enrolled (mean age; 71.7 +/- 10.7 yr, 60.6% male). PeAF was defined as episodes that are sustained > 7 days and not self-terminating, while permanent AF was defined as an ongoing long-term episode. Atrial arrhythmia during follow-up was defined as atrial premature complex, atrial tachycardia, and atrial flutter. During a mean follow-up of 72.7 +/- 58.3 months, 168 patients (38.7%) with PAF progressed to PeAF or permanent AF. The mean annual AF progression was 10.7% per year. In univariate analysis, age at diagnosis, body mass index, atrial arrhythmia during follow-up, left ventricular ejection fraction, concentric left ventricular hypertrophy, left atrial diameter (LAD), and severe mitral regurgitation (MR) were significantly associated with AF progression. In multivariate analysis, age at diagnosis (P = 0.009), atrial arrhythmia during follow-up (P = 0.015), LAD (P = 0.002) and MR grade (P = 0.026) were independent risk factors for AF progression. Patients with younger age at diagnosis, atrial arrhythmia during follow-up, larger left atrial chamber size, and severe MR grade are more likely to progress to PeAF or permanent AF, suggesting more intensive medical therapy with close clinical follow-up would be required in those patients.
