Effect of atrial fibrillation pattern on survival in a community-based cohort

Richard J. Keating, Bernard J. Gersh, David O. Hodge, Peggy L. Weivoda, Philip J. Patel, Stephen C. Hammill, Win Kuang Shen

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

The clinical presentation of recurrent atrial fibrillation (AF) has been categorized into 3 general patterns: paroxysmal, persistent, and permanent AF. This community-based cohort study characterized the effect of the AF pattern on survival. Community residents in Olmsted County, Minnesota, with electrocardiographically proven new-onset AF during 1996 and 1997 were retrospectively identified and prospectively followed. Observed survival was estimated using the Kaplan-Meier method and compared with the expected survival. Log-rank tests were used for group comparisons. The association between the baseline variables and mortality was assessed using Cox proportional hazards models. Of 270 patients (mean ± SD age 73 ± 14 years; 148 men [55%]), 143 had paroxysmal AF, 40 had persistent AF, and 87 had permanent AF. The cohort's observed survival was significantly worse than expected (p <0.001). The factors associated with increased mortality included older age, concomitant heart failure, and concomitant chronic obstructive pulmonary disease (all p <0.001). Permanent AF was associated with higher mortality than paroxysmal AF (hazard ratio 1.6, 95% confidence interval 1.1 to 2.3). Persistent AF was associated with better survival (hazard ratio 0.3, 95% confidence interval 0.1 to 0.8). In conclusion, survival among patients with persistent AF was significantly better than that among patients with paroxysmal AF or permanent AF. The ability to maintain sinus rhythm may be associated with better survival.

Original languageEnglish (US)
Pages (from-to)1420-1424
Number of pages5
JournalAmerican Journal of Cardiology
Volume96
Issue number10
DOIs
StatePublished - Nov 15 2005

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Fingerprint Dive into the research topics of 'Effect of atrial fibrillation pattern on survival in a community-based cohort'. Together they form a unique fingerprint.

  • Cite this

    Keating, R. J., Gersh, B. J., Hodge, D. O., Weivoda, P. L., Patel, P. J., Hammill, S. C., & Shen, W. K. (2005). Effect of atrial fibrillation pattern on survival in a community-based cohort. American Journal of Cardiology, 96(10), 1420-1424. https://doi.org/10.1016/j.amjcard.2005.07.050