title: Paroxysmal Atrial Fibrillation in the Course of Acute Pulmonary Embolism: Clinical Significance and Impact on Prognosis.
abstract: The relationship and clinical implications of atrial fibrillation (AF) in acute pulmonary embolism (PE) are poorly investigated. We aimed to analyze clinical characteristics and prognosis in PE patients with paroxysmal AF episode.Methods. From the 391 patients with PE 31 subjects with paroxysmal AF were selected. This group was compared with patients with PE and sinus rhythm (SR) and 32 patients with PE and permanent AF.Results. Paroxysmal AF patients were the oldest. Concomitant DVT varies between groups: paroxysmal AF 32.3%, SR 49.5%, and permanent AF 28.1% (p= 0.02). The stroke history frequency was 4.6% SR, 12.9% paroxysmal AF, and 21.9% permanent AF (p< 0.001). Paroxysmal AF comparing to permanent AF and SR individuals had higher estimated SPAP (56 versus 48 versus 47 mmHg,p= 0.01) and shorter ACT (58 versus 65 versus 70 ms,p= 0.04). Patients with AF were more often classified into high-risk group according to revised Geneva score and sPESI than SR patients. In-hospital mortality was lower in SR (5%) and paroxysmal AF (6.5%) compared to permanent AF group (25%) (p< 0.001).Conclusions. Patients with PE-associated paroxysmal AF constitute a separate population. More severe impairment of the parameters reflecting RV afterload may indicate relation between PE severity and paroxysmal AF episode. Paroxysmal AF has no impact on short-term mortality.
authors.affiliation: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors.forename: Agnieszka
authors.initials: A
authors.lastname: Krajewska
authors.affiliation: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors.forename: Katarzyna
authors.identifier: 0000-0002-6457-704X
authors.initials: K
authors.lastname: Ptaszynska-Kopczynska
authors.affiliation: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors.forename: Izabela
authors.initials: I
authors.lastname: Kiluk
authors.affiliation: Department of Cardiology, Procardia, Augustów, Poland.
authors.forename: Urszula
authors.initials: U
authors.lastname: Kosacka
authors.affiliation: Department of Statistics and Medical Informatics, Medical University of Białystok, Białystok, Poland.
authors.forename: Robert
authors.identifier: 0000-0001-6241-8283
authors.initials: R
authors.lastname: Milewski
authors.affiliation: Department of Anaesthesiology and Intensive Care, Medical University of Białystok, Białystok, Poland.
authors.forename: Jacek
authors.initials: J
authors.lastname: Krajewski
authors.affiliation: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors.forename: Wlodzimierz Jerzy
authors.initials: WJ
authors.lastname: Musial
authors.affiliation: Department of Cardiology, Medical University of Białystok, Białystok, Poland.
authors.forename: Bozena
authors.identifier: 0000-0002-3297-3320
authors.initials: B
authors.lastname: Sobkowicz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001281:Atrial Fibrillation / Q000150:complications* / Q000000981:diagnostic imaging; D005260:Female; D006760:Hospitalization; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011655:Pulmonary Embolism / Q000150:complications*; D016896:Treatment Outcome