Abstract P099: Atrial Flutter - Clinical Correlates and Adverse Outcomes in the Framingham Heart Study
Introduction: There has been little study of atrial flutter (AFl), distinct from atrial fibrillation, in community-based, epidemiologic cohorts. We determined the clinical correlates of AFl and its associated outcomes in the Framingham Heart Study.
Methods: We adjudicated electrocardiograms from study exams, and ambulatory and hospital records to identify typical AFl in participants without prevalent atrial fibrillation or AFl. We compared individuals with AFl to participants with neither atrial fibrillation nor AFl. We identified factors associated with a new diagnosis of AFl. We examined the 10-year risks of atrial fibrillation, myocardial infarction, heart failure, stroke, and all-cause mortality in Cox proportional hazards models with adjustment for age, sex, body mass index, systolic and diastolic blood pressures, hypertension treatment, diabetes mellitus and prevalent cardiovascular disease.
Results: During a follow-up of 33.0±12.2 years, 112 individuals developed AFl. In age- and sex-adjusted analyses, smoking (odds ratio [OR] 2.02; 95% confidence interval [CI] 1.21-3.37; P<0.01), moderate-to-heavy alcohol use (OR 2.48; 95% CI 1.10-5.55; P<0.05), increased PR interval (OR 1.50; 95% CI 1.21-1.86; P<0.001), myocardial infarction (OR 1.96; 95% CI 1.05-3.64; P<0.05), heart failure (OR 5.21; 95% CI 1.64-16.55; P<0.01), and stroke (OR 2.46; 95% CI 1.19-5.07; P<0.05) were associated with incident AFl. After multivariable adjustment, in individuals with AFl the 10-year risk was increased 14.1-fold for atrial fibrillation, 5.3-fold for myocardial infarction, 3.7-fold for heart failure, and 1.8-fold for mortality.
Conclusions: In our community-based cohort, we identified factors associated with AFl onset and found that AFl was associated with multiple adverse outcomes. Future studies should determine how treatment for AFl may modify its prognosis.
Author Disclosures: F. Rahman: None. N. Wang: None. X. Yin: None. P.T. Ellinor: None. S.A. Lubitz: None. P.A. LeLorier: None. D.D. McManus: None. E.J. Benjamin: None. J.W. Magnani: None.
- © 2015 by American Heart Association, Inc.