Prediction of atrial fibrillation in patients with an implantable cardioverter-defibrillator and heart failure

Bertini, Matteo, Borleffs, C. Jan Willem, Delgado, Victoria, Ng, Arnold C. T., Piers, Sebastiaan R. D., Shanks, Miriam, Antoni, M. Louisa, Biffi, Mauro, Boriani, Giuseppe, Schalij, Martin J., Bax, Jeroen J. and Van de Veire, Nico R. L. (2010) Prediction of atrial fibrillation in patients with an implantable cardioverter-defibrillator and heart failure. European Journal of Heart Failure, 12 10: 1101-1110. doi:10.1093/eurjhf/hfq126

Author Bertini, Matteo
Borleffs, C. Jan Willem
Delgado, Victoria
Ng, Arnold C. T.
Piers, Sebastiaan R. D.
Shanks, Miriam
Antoni, M. Louisa
Biffi, Mauro
Boriani, Giuseppe
Schalij, Martin J.
Bax, Jeroen J.
Van de Veire, Nico R. L.
Title Prediction of atrial fibrillation in patients with an implantable cardioverter-defibrillator and heart failure
Journal name European Journal of Heart Failure   Check publisher's open access policy
ISSN 1388-9842
Publication date 2010-10-01
Year available 2010
Sub-type Article (original research)
DOI 10.1093/eurjhf/hfq126
Volume 12
Issue 10
Start page 1101
End page 1110
Total pages 10
Place of publication Oxford, United Kingdom
Publisher Oxford University Press
Language eng
Formatted abstract
Aims Heart failure and atrial fibrillation (AF) frequently coexist and AF worsens heart failure prognosis. Device-based diagnostics derived from implantable cardioverter-defibrillator (ICD) interrogation provide an accurate method for detecting AF episodes. This study sought to determine clinical and echocardiographic predictors of AF occurrence, including an index of total atrial conduction time derived by tissue Doppler imaging (PA-TDI duration), in patients with heart failure. Moreover, the role of PA-TDI duration on the prediction of AF occurrence in subgroups of patients with and without history of AF was explored.

Methods and results A cohort of 495 heart failure patients who underwent ICD implantation was studied. Baseline echocardiographic parameters of systolic and diastolic function were evaluated together with clinical parameters. Furthermore, PA-TDI duration was measured. All patients were prospectively followed up after ICD implantation for AF occurrence detected by ICD interrogation. A total of 142 (29) patients experienced AF over a follow-up period of 16.4 ± 11.2 months. PA-TDI duration was longer in patients with AF occurrence when compared with patients without AF occurrence (154 ± 27 vs. 135 ± 24 ms, P < 0.001). On Cox-multivariable analysis, female gender [hazard ratio = 1.60; 95 confidence intervals (CI) = 1.09-2.35; P = 0.017], history of AF (hazard ratio = 2.22; 95 CI, 1.51-3.27; P < 0.001), and PA-TDI duration (hazard ratio = 1.27; 95 CI, 1.13-1.42; P < 0.001) were independent predictors of AF occurrence. In the subgroups of patients with and without history of AF, PA-TDI duration remained an independent predictor of AF occurrence.

Conclusion PA-TDI duration may be useful to risk-stratify for AF occurrence in heart failure patients with and without a history of AF.
Keyword Atrial fibrillation
Heart failure
Cardiac Resynchronization Therapy
Prognostic Significance
European Society
Q-Index Code C1
Q-Index Status Provisional Code
Institutional Status Non-UQ

Document type: Journal Article
Sub-type: Article (original research)
Collection: School of Medicine Publications
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Created: Tue, 30 Apr 2013, 21:14:57 EST by Dr Chin Tse Arnold Ng on behalf of School of Medicine