title: Prognosis in patients hospitalized with permanent and nonpermanent atrial fibrillation in heart failure.
abstract: Atrial fibrillation (AF) and heart failure (HF) frequently coexist and are associated with an increased mortality. This study evaluated the prognosis of permanent and nonpermanent AF in patients with both AF and HF. All AF patients seen in our institution were identified and followed up. We included 1,906 patients suffering from AF and HF: 839 patients (44%) had preserved left ventricular ejection fraction (LVEF) and 1,067 patients (56%) had decreased LVEF; 1,056 patients (55%) had nonpermanent AF and 850 patients (45%) had permanent AF. During a median follow-up of 1.9 years (interquartile range 0.3 to 5.0), 377 patients died, 462 were readmitted for HF, and 200 had stroke or thromboembolic events. In patients with decreased LVEF, the rate of death was similar in patients with permanent or nonpermanent AF. In patients with preserved LVEF, permanent AF was associated with a higher risk of death and a higher risk of HF hospitalization. Stroke risk did not differ with permanent AF whatever the LVEF. NYHA functional class was an independent predictor of death (risk ratio [RR]=1.33, 95% confidence interval [CI] 1.12 to 1.59, p=0.001), as was permanent AF (RR=1.79, 95%CI 1.32 to 2.42, p=0.0002). Permanent AF (RR=1.52, 95% CI 1.20 to 1.93, p=0.0006) was also an independent predictor of readmission for HF. In conclusion, in patients with AF and HF, the risk of admission for HF and risk of death were higher when AF was permanent, particularly in patients with preserved LVEF. Stroke risk did not differ according to the pattern of AF, whatever the LVEF.
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Sophie
authors: S
authors: Taillandier
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Anne
authors: A
authors: Brunet Bernard
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Benedicte
authors: B
authors: Lallemand
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Edouard
authors: E
authors: Simeon
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Lauriane
authors: L
authors: Pericart
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Nicolas
authors: N
authors: Clementy
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France.
authors: Dominique
authors: D
authors: Babuty
authors: Service de Cardiologie, Pôle Cœur Thorax Vasculaire, Centre Hospitalier Universitaire Trousseau, et Faculté de Médecine, Université François Rabelais, Tours, France. Electronic address: lfau@med.univ-tours.fr.
authors: Laurent
authors: L
authors: Fauchier
mesh_terms: D000367:Age Factors; D000368:Aged; D001281:Atrial Fibrillation / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D005602:France / Q000453:epidemiology; D006333:Heart Failure / Q000150:complications / Q000503:physiopathology / Q000628:therapy*; D017052:Hospital Mortality / Q000639:trends; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013318:Stroke Volume; D015996:Survival Rate / Q000639:trends; D013923:Thromboembolism / Q000453:epidemiology / Q000209:etiology*; D016277:Ventricular Function, Left