Abstract 2012: Prognostic Implication of Atrial Fibrillation in Patients with Heart Failure
The AFFIRM study demonstrated no outcome differences with rhythm or rate control strategies in atrial fibrillation (AF) patients (pts). However, an AFFIRM subanalysis revealed a net benefit from sinus rhythm. Little is known about the prognostic implication of AF in patients with heart failure (HF). A prospective registry of pts with HF and AF was started in 2000 in order to evaluate the variables associated to mortality and rehospitalisation in such patients and to determine the implication on quality of life (assessed by LVD-36 questionnaire). In the present study we included 832 HF pts (mean age 71±14yrs, mean NYHA class 2.8±0.8). 247 pts had AF; with the exception of predominance of females in this group, other variables were not significantly different for pts without AF. During the follow up period of 42±7mo, 241 pts (29%) died. For all the cohort, a multivariate model controlling for different variables demonstrated that age, renal function, anemia, decrease in ejection fraction and diabetes are predictors for mortality (OR: 1.4, p< 0.001, 1.4, p< 0.05, 1.3, p:0.03, 1.5, p=0.03, 1.4, p=0,01 respectively), but AF is not. Concerning rehospitalisations, age was again a strong predictor (OR 1.6), but AF and renal function were also predictors (OR 1.3 for both variables). Quality of life was slightly higher in pts without AF (p<0.05). Matching for the heart rate in pts with or without AF no significant differences were noted in mortality or rehospitalisations.
Conclusions: Our study demonstrated no independent prognostic impact on mortality for AF in patients with HF. However, AF could have implications on rehospitalisations and quality of live in HF patients.