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Is Mortality in Patients with Atrial Fibrillation Related to the Underlying Heart Disease or to the Arrhythmia?

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Abstract

Atrial fibrillation (AF) is considered one of the most common clinically relevant cardiac arrhythmias. The prevalence of AF increases with age and is reported to be 0.2%–0.3% at age 25 – 35 years, 3%–4% at age 55 – 64 years, and 5%–9% at age 62 – 90 years (1). AF is usually a consequence of heart disease involving the left atrium, but may also result from extracardiac conditions such as hyperthyroidism, surgery, acute alcohol intoxication, cholinergic drug use, or diagnostic procedures. In a minority of patients, no contributing factors or overt heart disease can be identified (lone AF). In most cases the clinical and hemodynamic consequences of AF are related to the severity of underlying heart disease.

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References

  1. Kannel WB, Wolf PA (1992) Epidemiology of atrial fibrillation. In: Falk RH, Podrid PJ (eds) Atrial fibrillation. Mechanisms and management. Raven, New York, pp 81–92

    Google Scholar 

  2. Ruskin J, McHale PA, Harley A, Greenfield JC Jr (1970) Pressure-flow studies in man: effects of atrial systole on left ventricular function. J Clin Invest 49: 472–478

    Article  PubMed  CAS  Google Scholar 

  3. Atwood JE (1992) Exercise hemodynamics of atrial fibrillation. In: Falk RH, Podrid PJ (eds) Atrial fibrillation. Mechanism and management. Raven, New York, pp 145–163

    Google Scholar 

  4. Rahimtoola SH, Ehsani A, Sinno MZ et al (1975) Left atrial transport function in myocardial infarction: importance of its booster function. Am J Med 59: 686–693

    Article  PubMed  CAS  Google Scholar 

  5. Greenberg B, Chatterjee K, Parmley WW, Werner JA, Holly AN (1980) The influence of left ventricular filling pressure on atrial contribution to cardiac output. Am Heart J 98: 742751

    Google Scholar 

  6. Pehrsson SK (1983) Influence of heart rate and atrioventricular synchronization on maximal work tolerance in patients treated with artificial pacemaker. Acta Med Scand 214: 311–315

    Article  PubMed  CAS  Google Scholar 

  7. Ausubel K, Steingart RM, Shimshi M, Klementowicz P, Furman S (1985) Maintenance of exercise stroke volume during ventricular versus atrial synchronous pacing: role of contractility. Circulation 72: 1037

    Article  PubMed  CAS  Google Scholar 

  8. Fananapazir L, Bennet DH, Monks P (1983) Atrial synchronized ventricular pacing: contribution of the chronotropic response to improved exercise performance. Pace 6: 601–605

    Article  PubMed  CAS  Google Scholar 

  9. Fananapazir L, Srinivas V, Bennet DH (1983) Comparison of resting hemodynamic indices and exercise performance during atrial synchronized and asynchronous ventricular pacing. Pace 6: 202–206

    Article  PubMed  CAS  Google Scholar 

  10. Naito M, David D, Michelson EL, Schaffenburg M, Dreifus LS (1983) The hemodynamic consequences of cardiac arrhythmias: evaluation of the relative roles of abnormal atrioventricular sequencing, irregularity of ventricular rhythm and atrial fibrillation in a canine model. Am Heart J 106: 284–291

    Article  PubMed  CAS  Google Scholar 

  11. Piccolo E, Di Pede F, Millosevich P (1993) Ablazione transcatetere della giunzione AV ed impianto di Pace-Maker in pazienti con fibrillazione e flutter atriale: la regolarizzazione dei cicli ventricolari migliora la funzione cardiaca? In: Piccolo E, Raviele A (eds) Third International Workshop on Cardiac Arrythmias, Venice, 21–23 October 1993. Centro Scientifico Editore, Torino, pp 79–92

    Google Scholar 

  12. Packer DL, Bardy GH, Worley SJ, Smith MS, Cobb FR, Coleman E, Gallagher JJ, German LD (1986) Tachycardia-induced cardiomyopathy: a reversible form of left ventricular dysfunction. Am J Cardiol 57: 563–570

    Article  PubMed  CAS  Google Scholar 

  13. McLaran CJ, Gersh Bi, Sugrue DD, Hammill SC, Seward JB, Holmes DR Jr (1985) Tachycardia induced myocardial dysfunction: a reversible phenomenon? Br Heart J 53: 323–327

    Article  PubMed  CAS  Google Scholar 

  14. Leather RA, Kerr CR (1992) Atrial fibrillation in the absence of overt cardiac disease. In: Falk RH, Podrid PJ (eds) Atrial fibrillation: mechanisms and management. Raven, New York, pp 93–108

    Google Scholar 

  15. Grogan M, Smith HC, Gersh BJ, Wood DL (1992) Left ventricular dysfunction due to atrial fibrillation in patients initially believed to have idiopathic dilated cardiomyopathy. Am J Cardiol 69: 1570–1573

    Article  PubMed  CAS  Google Scholar 

  16. Selzer A (1960) Effects of atrial fibrillation upon the circulation in patients with mitral stenosis. Am Heart J 59: 518–526

    Article  PubMed  CAS  Google Scholar 

  17. Graettinger JS, Carleton RA, Muenster JJ (1964) Circulatory consequences of changes in cardiac rhythm produced in patients by transthoracic direct-current shock. J Clin Invest 43: 2290–2295

    Article  PubMed  CAS  Google Scholar 

  18. Morris JJ, Entman M, North WC et al (1965) The changes in cardiac output with reversion of atrial fibrillation to sinus rhythm. Circulation 31: 670–678

    PubMed  Google Scholar 

  19. Reale A (1965) Acute effects of countershock conversion of atrial fibrillation upon right and left heart hemodynamics. Circulation 32: 214–222

    PubMed  CAS  Google Scholar 

  20. Killip T, Baer R (1965) Hemodynamic effect after reversion from atrial fibrillation to sinus rhythm by precordial shock. J Clin Invest 45: 658–670

    Article  Google Scholar 

  21. Shapiro W, Klein G (1968) Alterations in cardiac function immediately following electrical conversion of atrial fibrillation to normal sinus rhythm. Circulation 38: 1074–1078

    PubMed  CAS  Google Scholar 

  22. Glancy DL, O’Brein KP, Gold HK et al (1970) Atrial fibrillation in patients with idiopatic hypertrophie subaortic stenosis. Am Heart J 32: 652–658

    CAS  Google Scholar 

  23. Di Pede F, Raviele A, Zuin G et al (1987) Quando, come e perché riconverire a ritmo una fibrillazione atriale. In: Raviele A, Alboni P (eds) Third International Workshop on Cardiac Arrythmias, Venice, 21–23 October 1993. 11 Pensiero Scientifico Editore, Rome, pp 55–62

    Google Scholar 

  24. Piccolo E, Delise P, Alboni P et al (1991) Problemi elettrofisiologici e clinici della fibrillazione atriale. G Ital Cardiol 21: 437–459

    Google Scholar 

  25. Scarfò S, Papparella N, Fucà G, Yannacopulu P, Alboni P (1993) Perché conquistare a tutti i costi it ritmo sinusale? Quale vantaggio emodinamico per it paziente? G Hal Cardiol 23 [Sup-pl I]: 98–102

    Google Scholar 

  26. Atwood JE, Myers J, Sullivan M et al (1988) Maximal exercise testing and gas exchange in patients with chronic atrial fibrillation. J Am Coll Cardiol 11: 508–513

    Article  PubMed  CAS  Google Scholar 

  27. Manning W, Leeman DE, Gotch PJ, Come PC (1989) Pulsed Doppler evaluation of atrial mechanical function after electrical cardioversion of atrial fibrillation. J Am Coll Cardiol 13: 617–623

    Article  PubMed  CAS  Google Scholar 

  28. Pollick C (1992) Echocardiography in atrial fibrillation. In: Falk RH, Podrid PJ (eds) Atrial fibrillation: mechamisms and management. Raven, New York, pp 165–180

    Google Scholar 

  29. Sanfilippo AJ, Abascal VM, Sheehan M et al (1990) Atrial enlargement has a consecuence of atrial fibrillation. A prospective echocardiographic study. Circulation 82: 791–797

    Article  Google Scholar 

  30. Van Gelder IC, Crijns HJ, Van Gilst WH, Hamer HPM, Lie KI (1991) Decrease of right and left atrial size after direct current electrical cardioversion in chronic atrial fibrillation. Am J Cardiol 67: 93–95

    Article  PubMed  Google Scholar 

  31. Hinton RC, Kistler JP, Fallon JT, Friedlich AL, Fisher CM (1977) Influence of etiology of atrial fibrillation on incidence of systemic embolism. Am J Cardiol 40: 509–513

    Article  PubMed  CAS  Google Scholar 

  32. Wolf PA, Dawber TR, Thomas HE, Kannel WB (1978) Epidemiologic assessment of chronic atrial fibrillation and risk of stroke: the Framingham study. Neurology 28: 973–977

    PubMed  CAS  Google Scholar 

  33. Albers GW, Atwood JE, Hirsh J, Sherman DG, Hughes RA, Connolly SJ (1991) Stroke prevention in nonvalvular atrial fibrillation. Ann Intern Med 115: 727–736

    PubMed  CAS  Google Scholar 

  34. Wolf PA, Abbott RD, Kannel WB (1987) Atrial fibrillation: major contributor to stroke in the elderly. Arch Intern Med 147: 1561–1564

    Article  PubMed  CAS  Google Scholar 

  35. Stroke Prevention in Atrial Fibrillation Study Group Investigators (1990) Preliminary report of the Stroke Prevention in Atrial Fibrillation Study. N Engl J Med 322: 863–868

    Google Scholar 

  36. Fisher CM (1979) Reducing risk of cerebral embolism. Geriatrics 34: 59–66

    PubMed  CAS  Google Scholar 

  37. Stroke Prevention in Atrial Fibrillation Investigators (1992) Predictors of thromboembolism in atrial fibrillation. I. Clinical features of patients at risk. Ann Intern Med 116: 1–5

    Google Scholar 

  38. Flegel KM, Hanley J (1989) Risk factors for stroke and other embolic events in patients with nonrheumatic atrial fibrillation. Stroke 20: 1000–1004

    Article  PubMed  CAS  Google Scholar 

  39. Cairns JA, Connolly SJ (1991) Nonrheumatic atrial fibrillation: risk of stroke and role of antithrombotic theraphy. Circulation 84: 469–481

    PubMed  CAS  Google Scholar 

  40. Kannel WB, Abbott RD, Savage DD, McNamara PM (1982) Epidemiologic features of chronic atrial fibrillation: the Framingham study. N Engl J Med 306: 1018–1022

    Article  PubMed  CAS  Google Scholar 

  41. Onundarson PT, Thorgeirsson G, Jonmundsson E, Sigfusson N, Hardson T (1987) Chronic atrial fibrillation — epidemiologic features and 14 year follow-up: a case control study. Eur Heart J 3: 521–527

    Google Scholar 

  42. Kitchin AH, Milne JS (1977) Longitudinal survey of ischaemic heart disease in randomly selected sample of older population. Br Heart J 39: 889–893

    Article  PubMed  CAS  Google Scholar 

  43. Petersen P, Boysen G, Godtfredsen J, Andersen E, Andersen B (1989) Placebo-controlled, randomised trial of warfarin and aspirin for prevention of thromboembolic complications in chronic atrial fibrillation. Lancet 1: 175–178

    Article  PubMed  CAS  Google Scholar 

  44. The Boston Area Anticoagulation Trial for Atrial Fibrillation Investigators (1990) The effect of low-dose warfarin on the risk of stroke in patients with nonrheumatic atrial fibrillation. N Engl J Med 323: 1505–1511

    Article  Google Scholar 

  45. Stroke Prevention in Atrial Fibrillation Investigators (1991) Stroke prevention in atrial fibrillation study. Final results. Circulation 84: 527–539

    Google Scholar 

  46. Evans W, Swann P (1954) Lone auricular fibrillation. Br Heart J 16: 189–194

    Article  PubMed  CAS  Google Scholar 

  47. Kopecky SL, Gersh BJ, McGoon MD, Whisnant JP, Holmes DR, Ilstrup DM, Frye RL (1987) The natural history of lone atrial fibrillation. N Engl J Med 317: 669–674

    Article  PubMed  CAS  Google Scholar 

  48. Gajewski J, Singer RB (1981) Mortality in an insured population with atrial fibrillation. JAMA 245: 1540–1544

    Article  PubMed  CAS  Google Scholar 

  49. Carson PE, Johnson GR, Dunkman WB, Fletcher RD, Farrell L, Cohn JN (1993) The influence of atrial fibrillation on prognosis in mild to moderate heart failure. Circulation 87 [Suppl VI]: 102–110

    Google Scholar 

  50. Middlekauff HR, Stevenson WG, Stevenson LW (1991) Prognostic significance of atrial fibrillation in advanced heart failure. A study of 390 patients. Circulation 84: 40–48

    PubMed  CAS  Google Scholar 

  51. Keogh AM, Baron DW, Hickie JB (1990) Prognostic guides in patients with idiopathic or ischemic dilated cardiomyopathy assessed for cardiac transplantation. Am J Cardiol 65: 903–908

    Article  PubMed  CAS  Google Scholar 

  52. Unverferth DV, Magorien RD, Moescberger ML, Baker PB, Fetters JK, Leier CV (1984) Factors influencing the one-year mortality of dilated cardiomyopathy. Am J Cardiol 54: 147–152

    Article  PubMed  CAS  Google Scholar 

  53. Cameron A, Schwartz MJ, Kronmal RA, Kosinski AS (1988) Prevalence and significance of atrial fibrillation in coronary artery disease ( CASS Registry ). Am J Cardiol 61: 714–717

    Google Scholar 

  54. Kannel WB, Abbott RD, Savage DD, McNamara PM (1983) Coronary heart disease and atrial fibrillation: the Framingham study. Am Heart J 106: 389–396

    Article  PubMed  CAS  Google Scholar 

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© 1996 Springer-Verlag Italia, Milano

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Di Pede, F., Zuin, G. (1996). Is Mortality in Patients with Atrial Fibrillation Related to the Underlying Heart Disease or to the Arrhythmia?. In: Raviele, A. (eds) Cardiac Arrhythmias 1995. Springer, Milano. https://doi.org/10.1007/978-88-470-2223-2_39

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  • DOI: https://doi.org/10.1007/978-88-470-2223-2_39

  • Publisher Name: Springer, Milano

  • Print ISBN: 978-3-540-75012-3

  • Online ISBN: 978-88-470-2223-2

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