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- Title
Fibrillation cycle length predicts cardiovascular events in patients with long-standing persistent atrial fibrillation.
- Authors
Nakamura, Hironori; Niwano, Shinichi; Fukaya, Hidehira; Kishihara, Jun; Satoh, Akira; Oikawa, Jun; Yoshizawa, Tomoharu; Ishizue, Naruya; Igarashi, Tazuru; Fujiishi, Tamami; Nishinarita, Ryo; Horiguchi, Ai; Ako, Junya
- Abstract
Background: Atrial fibrillation (AF) is associated with an increased risk of heart failure (HF), stroke, and death. Although fibrillation cycle length (FCL) is used as a surrogate for atrial refractoriness, its impact on outcomes remains unclear. This study aimed to identify predictors of cardiovascular events, including FCL, in patients with long-standing persistent AF. Methods: The study included 190 consecutive patients with long-standing persistent AF (mean age 74 years, 74% male). Patients with valvular AF or hemodialysis-dependent end-stage renal disease and those on anti-arrhythmic drugs were excluded. The primary composite outcome was occurrence of cardiovascular events (myocardial infarction, HF), cerebrovascular events (stroke, transient ischemic attack), and all-cause death. FCL was calculated by fast Fourier transformation analysis of fibrillation waves in the surface electrocardiogram. Results: Over a median follow-up of 2.6 years, the primary outcome occurred in 31 patients (cardiovascular events, n = 18; cerebrovascular events, n = 8; all-cause death, n = 5). In multivariate analysis, longer FCL and history of HF were independent predictors of these outcomes. In a Cox proportional hazards model adjusted for age, sex, and history of HF, patients with an FCL > 160 ms (cut-off determined by receiver-operating characteristic curve analysis) were at increased risk of the outcome (hazard ratio 12.9; 95% confidence interval 4.99–44.10; p < 0.001). Conclusions: FCL was independently associated with cardiovascular outcomes in patients with long-standing persistent AF.
- Subjects
ATRIAL fibrillation; PROPORTIONAL hazards models; TRANSIENT ischemic attack; CHRONIC kidney failure; FOURIER transforms
- Publication
Heart & Vessels, 2022, Vol 37, Issue 6, p1027
- ISSN
0910-8327
- Publication type
Article
- DOI
10.1007/s00380-021-01993-x