title: Principal atrial fibrillation discharges by the new ACC/AHA/ESC classification.
abstract: BACKGROUND
  The American College of Cardiology, American Heart Association, and European Society of Cardiology Board (ACC/AHA/ESC) 2001 guidelines for management of patients with atrial fibrillation (AF) include a new classification system consisting of 4 categories: first-detected episode; recurrent paroxysmal (self-terminating); recurrent persistent (requiring cardioversion); and permanent. The frequency of hospital discharges within these categories has not been reported.
  
  
  METHODS
  The new classification system was applied to 135 consecutive hospital discharges with a principal diagnosis of AF.
  
  
  RESULTS
  Classification of AF in these discharged patients included 74 (55%) with first-detected episode; 28 (21%) with recurrent paroxysmal AF; 17 (13%) with recurrent persistent AF; and 16 (12%) with permanent AF. Hypertension (n = 48; 35%) was the most common primary cause of AF, followed by alcohol related (n = 23; 17%), coronary artery disease (n = 20; 15%), and valvular heart disease (n = 17; 12%). For the 102 patients with first-detected and recurrent paroxysmal AF, 71 (69%) converted spontaneously to normal sinus rhythm within 48 hours of admission. Of the 48 patients with a discharge diagnosis of AF, 32 (67%) were receiving anticoagulation therapy.
  
  
  CONCLUSIONS
  Most hospital discharges with a principal diagnosis of AF represent the first-detected episode. Diverse causes contribute to AF, and to examine them would help direct therapy. Importantly, in our analysis, 69% of those patients with first-detected or recurrent paroxysmal AF converted spontaneously to normal sinus rhythm within 48 hours of admission.
authors.affiliation: Hennepin County Medical Center, Minneapolis, MN 55415, USA. asing001@umn.edu
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Dixon
authors.forename: Yiscah
authors.initials: Y
authors.lastname: Bracha
authors.forename: Steven W
authors.initials: SW
authors.lastname: Loecke
authors.forename: Marco A
authors.initials: MA
authors.lastname: Guerrero
authors.forename: Richard D
authors.initials: RD
authors.lastname: Taylor
authors.forename: Richard W
authors.initials: RW
authors.lastname: Asinger
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000145:classification* / Q000453:epidemiology* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D014481:United States / Q000453:epidemiology