当前位置： SCI文献检索 > HEART RHYTHM期刊下所有文献 > Typical, atypical, and asymptomatic presentations of new-onset atrial fibrillation in the community: Characteristics and prognostic implications.

Typical, atypical, and asymptomatic presentations of new-onset atrial fibrillation in the community: Characteristics and prognostic implications.

Abstract：

BACKGROUND:The prognostic significance of the clinical presentation of atrial fibrillation (AF) is poorly defined. OBJECTIVE:The purpose of this study was to determine the frequency, associations, and prognostic impact of different clinical presentations of new-onset AF. METHODS:One thousand patients with incident AF in Olmsted County, Minnesota, were randomly selected (2000-2010). Patients with AF that was complicated at presentation (heart failure [n = 71], thromboembolism [n = 24]), provoked (n = 346), or unable to determine symptoms (n = 83) were excluded. In the remaining patients, characteristics and prognosis associated with different types of symptoms were examined. RESULTS:Among 476 patients, 193 had typical (palpitations), 122 had atypical (other non-palpitation symptoms), and 161 had asymptomatic AF presentation. Patients with typical presentation had lower CHA2DS2-VASc scores (mean 2.3 ± 2) compared to atypical and asymptomatic presentation (mean 3.2 ± 1.8 and 3.3 ± 1.9, respectively; P <.001). Fifty-nine cerebrovascular events and 149 deaths (n = 49 cardiovascular) were documented over median 5.6 and 6.0 years, respectively. Atypical and asymptomatic AF conferred higher risks of cerebrovascular events compared to typical AF after adjustment for CHA2DS2-VASc score and age (hazard ratio [HR] 3.51, 95% confidence interval [CI] 1.65-7.48, and HR 2.70, 95% CI 1.29-5.66, respectively), and associations remained statistically significant after further adjustments including comorbidities and warfarin use. Asymptomatic AF was associated with an increased risk of cardiovascular (HR 3.12, 95% CI 1.50-6.45) and all-cause mortality (HR 2.96, 95% CI 1.89-4.64) compared to typical AF after adjustment for CHA2DS2-VASc score and age. CONCLUSION:The type of clinical presentation may have important implications for the prognosis of new-onset AF in the community.

journal_name

Heart Rhythm

journal_title

Heart rhythm

authors

Siontis KC,Gersh BJ,Killian JM,Noseworthy PA,McCabe P,Weston SA,Roger VL,Chamberlain AM

doi

10.1016/j.hrthm.2016.03.003

subject

Has Abstract

pub_date

2016-07-01 00:00:00

pages

1418-24

issue

eissn

1547-5271

issn

1556-3871

pii

S1547-5271(16)30004-2

journal_volume

pub_type

杂志文章

在线工具

Typical, atypical, and asymptomatic presentations of new-onset atrial fibrillation in the community: Characteristics and prognostic implications.