title: The natural history of multifocal atrial rhythms in elderly outpatients: insights from the "Ikaria study".
abstract: BACKGROUND
  Multifocal atrial tachycardias confer an adverse prognosis in hospitalized patients. We assessed the prognostic impact of multifocal atrial rhythms (MARs-either chaotic atrial rhythm or multifocal atrial tachycardia/bradycardia) in very elderly outpatients.
  
  
  METHODS
  One hundred ten subjects aged 60-74 years, 112 aged 75-89 years, and 61 over 90 years old, were enrolled and prospectively evaluated. Several demographic and clinical characteristic were recorded in all individuals.
  
  
  RESULTS
  A high prevalence of MARs was detected in the study population (namely, 6%), which in subjects >90 years was even higher (15%). Individuals with MARs were older, more often female and less active. In multivariate analysis, independent predictors of MARs were age (OR = 1.07, 95% CI: 1.02-1.13, P = 0.01) and female sex (OR = 4.77, 95% CI: 1.23-18.48, P = 0.02). The mortality rate during the follow-up period was 8.4% without differences between age groups (P = 0.209). In particular, mortality rate was 6% in individuals with MARs and 9% in those without (P = 0.72). Mortality was associated with age (OR 1.07, 95% CI: 1.02-1.12, P = 0.005) and history of cardiovascular disease at baseline (OR 4.57, 95% CI: 1.87-11.2 P = 0.001).
  
  
  CONCLUSIONS
  Contrary to hospitalized individuals with multifocal atrial tachycardias, MARs were not associated with increased mortality in elderly outpatients in this study.
authors.affiliation: 1st Cardiology Department, University of Athens Medical School, "Hippokration" Hospital, Athens, Greece.
authors.forename: George
authors.initials: G
authors.lastname: Lazaros
authors.forename: Christina
authors.initials: C
authors.lastname: Chrysohoou
authors.forename: Evaggelos
authors.initials: E
authors.lastname: Oikonomou
authors.forename: Dimitrios
authors.initials: D
authors.lastname: Tsiachris
authors.forename: Savvas
authors.initials: S
authors.lastname: Mazaris
authors.forename: Erifili
authors.initials: E
authors.lastname: Venieri
authors.forename: Kostas
authors.initials: K
authors.lastname: Zisimos
authors.forename: Marina
authors.initials: M
authors.lastname: Zaromytidou
authors.forename: Maria
authors.initials: M
authors.lastname: Kariori
authors.forename: Stamatis
authors.initials: S
authors.lastname: Kioufis
authors.forename: Christos
authors.initials: C
authors.lastname: Pitsavos
authors.forename: Christodoulos
authors.initials: C
authors.lastname: Stefanadis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000453:epidemiology* / Q000503:physiopathology*; D004452:Echocardiography; D004562:Electrocardiography; D005260:Female; D006115:Greece / Q000453:epidemiology; D006325:Heart Atria / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010045:Outpatients; D015995:Prevalence; D011379:Prognosis; D011446:Prospective Studies
keywords: Ikaria study; electrocardiography; multifocal atrial rhythms; nonagenariars; prognosis
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