@article{3124965,
    title = "Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis",
    author = "Imazio, M. and Lazaros, G. and Picardi, E. and Vasileiou, P. and Orlando, F. and Carraro, M. and Tsiachris, D. and Vlachopoulos, C. and Georgiopoulos, G. and Tousoulis, D. and Belli, R. and Gaita, F.",
    journal = "British Heart Journal",
    year = "2015",
    volume = "101",
    number = "18",
    pages = "1463-1467",
    publisher = "BMJ Publishing Group",
    doi = "10.1136/heartjnl-2014-307398",
    keywords = "anticoagulant agent;  anticoagulant agent, adult;  adverse outcome;  Article;  atrial fibrillation;  bleeding;  cardiovascular mortality;  constrictive pericarditis;  controlled study;  female;  follow up;  heart arrhythmia;  heart atrium flutter;  heart tamponade;  human;  major clinical study;  male;  middle aged;  pericarditis;  priority journal;  prognosis;  recurrence risk;  recurrent disease;  acute disease;  aged;  atrial fibrillation;  complication;  incidence;  Italy;  pathophysiology;  risk factor;  time, Acute Disease;  Aged;  Anticoagulants;  Atrial Fibrillation;  Female;  Follow-Up Studies;  Humans;  Incidence;  Italy;  Male;  Middle Aged;  Pericarditis;  Prognosis;  Recurrence;  Risk Factors;  Time Factors",
    abstract = "Objective: Data on the incidence of new onset atrial fibrillation and flutter (AF/f) in patients with acute pericarditis are limited. We sought to determine the incidence and prognostic significance of AF/f in this setting. Methods: Between January 2006 and June 2014, consecutive new cases of acute pericarditis were included in two urban referral centres for pericardial diseases. All new cases of AF/f defined as episodes lasting ≥30 s were recorded. Events considered during follow-up consisted of AF/f and pericarditis recurrence, cardiac tamponade, pericardial constriction and death. Results:822 consecutive new cases of acute pericarditis (mean age 53±15 years, 444 men) were analysed. AF/f was detected in 35 patients (4.3%, mean age 66.5±11.3 years, 18 men). Patients with AF/f were significantly older (p=0.017) and presented more frequently with pericardial effusion (p<0.001). Arrhythmias developed within 24 h of pericarditis onset in 91.4% of cases, lasted >24 h in 25.7% and spontaneously converted in 74.3% of patients. Underlying structural heart disease was present in 17% of AF/f cases. In a 30-month follow-up, patients with history of AF/f at the initial episode had a higher rate of arrhythmia occurrence (34.3% vs 0.9%, p<0.001), mostly (75%) within 3 months. No other differences were detected in additional clinical events including haemorrhagic complications in patients receiving oral anticoagulation. Conclusions: The occurrence of AF/f in acute pericarditis identifies a predisposed population to AF/f with a high recurrence risk (about 35%): in these patients, pericarditis may act as an arrhythmic trigger and oral anticoagulation should be seriously considered according to guidelines."
}