Abstract 2513: Follow-up for First-Episode Atrial Fibrillation Patients
Background: ACC/AHA/ESC guidelines categorize atrial fibrillation (AF) into four groups:
The follow-up of first-episode AF patients with regards to subsequent AF category has not been reported.
Methods: This was a retrospective study of 208 consecutive hospitalized patients discharged with a principal diagnosis of AF between January 2000 and December 2002. The study was conducted at a single-site urban hospital. ACC/AHA/ESC AF guidelines were used to categorize patients at hospital discharge and last follow-up. Patients who had less than 30 day follow-up or who underwent ablation therapy were excluded. We analyzed routine clinical parameters including age, sex, hypertension, peripheral vascular disease, diabetes, hyperlipidemia, structural and functional heart disease, smoking, alcohol use, and COPD for differences in groups.
Results: One hundred eleven of the 208 discharged patients with a principal diagnosis of AF were first-episode AF patients. Eighty-four of these met inclusion criteria. Twenty-three patients were excluded because of follow-up less than 30 days, while 4 patients were excluded because of ablation therapy. Mean follow-up of these 84 was 2.8 years (range 1– 67 months). Thirty-four (40%) of our first-episode patients had no recurrence of AF, while 14 (17%) were reclassified as paroxysmal, 19 (23%) as persistent, and 17 (20%) as permanent at follow-up. On univariate analysis, those without recurrence of AF were younger (54+/−18yrs vs.65+/−17yrs).
Conclusion: Most patients discharged with a principal diagnosis of AF were hospitalized for their first documented episode of AF. Forty percent of first episode patients had no recurrence of AF, while 40% were reclassified as recurrent (17% paroxysmal and 23% persistent), and 20% permanent. The sole clinical variable that distinguished first-episode patients without recurrent AF from the other categories at follow-up was age–those without recurrence were younger.