Abstract 18839: Predictors of Atrial Fibrillation Progression and Cardiovascular Outcome in Patients With Young-Onset Atrial Fibrillation
Introduction: Atrial fibrillation (AF) often progresses to permanent AF. Progression is associated with cardiovascular outcome. We aim to study predictors of AF progression and outcome in young AF patients.
Methods: A total of 468 patients of the single-center, observational Phenotyping Young-onset Atrial Fibrillation Patients registry (YOUNG-AF) were included. All patients developed AF at an age <60 years and had paroxysmal or persistent AF. Follow up data on development of permanent AF and cardiovascular outcomes were prospectively collected. Cox proportional hazards regression analysis was used to find predictors of AF progression. Heart failure was defined as heart failure requiring hospitalization or an left ventricular ejection fraction (LVEF) <45%.
Results: Age was 49±9 years, 354 (76%) were men, median AF history was 14 [3-35] months and 304 (74%) had paroxysmal AF. Hypertension was present in 207 (44%) and 44 (9%) had heart failure. Median CHA2DS2-VASc was 1 [0-2]. LVEF was 60 [55-60]%, left atrial size was 41±6 mm. During follow up of 7.2 [2.7-10.0] years, 56 (12%) progressed to permanent AF. Patients with progression had more often heart failure (10 [18%] vs 34 [8%], p=0.028) and valvular disease (8 [14%] vs 27 [7%], p=0.05), longer PR interval (165 ms [157-188] vs 160 [144-174], p=0.052) and were more often men (49 [88%] vs 305 [74%], p=0.03). Univariable predictors (p<0.1) of AF progression were heart failure, PR interval and men (Table 1). Corrected for sex and treatment during follow-up, heart failure remained as predictor of AF progression. Young patients with AF progression had more cardiovascular events (16 [29%] vs 48 [12%]; HR 2.12 [1.20-3.73]; p=0.01), including heart failure admissions (11% vs 2%; p=0.001) and implantable cardioverter-defibrillator implantations (11% vs 5%; p=0.001).
Conclusions: In young patients with AF, heart failure is a predictor of progression to permanent AF. Patients with AF progression had more cardiovascular events.
Author Disclosures: R.R. De With: None. A.H. Hobbelt: None. J.N. Wessels: None. I.C. Van Gelder: None. M. Rienstra: None.
- © 2016 by American Heart Association, Inc.