title: Incidence and predictors of atrial fibrillation and its impact on long-term survival in patients with supraventricular arrhythmias.
abstract: OBJECTIVE
  To determine the incidence and predictors of atrial fibrillation (AF) and its impact on survival in patients with other forms of supraventricular arrhythmias (SVAs) including atrial flutter (AFL), atrial tachycardia (AT), atrioventricular reentrant (AVRT), and AV nodal reentrant tachycardia (AVNRT). We hypothesized that SVA may increase risk of AF and concomitant AF may influence long-term survival.
  
  
  RESULTS
  All patients who underwent catheter ablation for SVA from 2000 to 2010 were included in this study. The patients were identified retrospectively and the vital status determined prospectively. Observed survival in the study cohort was compared with survival rates in the age- and sex-matched general population. The study group included 1573 patients (mean age 50.5 ± 18 years, 47% female) with AVNRT (38.5%), AFL (29.6%), AVRT (22.6%) and AT (9.3%). The patients were followed for a mean of 35 months (median 23 months). Atrial fibrillation was documented in 424 patients (27%) with a higher incidence in males (35 vs. 18%). Atrial fibrillation was present in 19.6% of patients before the ablation and developed in 9.07% after ablation. Atrial fibrillation commonly occurred in patients with AFL (57.5%), AT (27.4%), AVRT (13.5%), and AVNRT (9.7%). Older age, prolonged PR interval, dilated left atrium, low left ventricular ejection fraction and presence of AFL were independent predictors for concomitant AF. Long-term survival was worse in the presence of AF.
  
  
  CONCLUSIONS
  The incidence of AF is high in patients with other forms of SVA. The most common association is between AFL and AF. Long-term survival is decreased in those who have concomitant AF, although AF did not emerge as an independent predictor of mortality when adjusted for other covariates.
authors.affiliation: Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA Division of Cardiovascular Medicine, University at Buffalo School of Medicine and Biomedical Sciences, NY, USA.
authors.forename: Cevher
authors.initials: C
authors.lastname: Ozcan
authors.affiliation: Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Jordan B
authors.initials: JB
authors.lastname: Strom
authors.affiliation: Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: John B
authors.initials: JB
authors.lastname: Newell
authors.affiliation: Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA.
authors.forename: Moussa C
authors.initials: MC
authors.lastname: Mansour
authors.affiliation: Cardiac Arrhythmia Service, Institute for Heart, Stroke and Vascular Care, Massachusetts General Hospital, Boston, MA, USA jruskin@partners.org.
authors.forename: Jeremy N
authors.initials: JN
authors.lastname: Ruskin
mesh_terms: D001281:Atrial Fibrillation / Q000453:epidemiology* / Q000209:etiology*; D001282:Atrial Flutter / Q000150:complications / Q000601:surgery; D017115:Catheter Ablation; D015897:Comorbidity; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D015996:Survival Rate; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000150:complications / Q000601:surgery; D013617:Tachycardia, Supraventricular / Q000150:complications / Q000601:surgery
keywords: Ablation; Atrial fibrillation; Predictors; Supraventricular tachycardia; Survival