TY - JOUR
TI - Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis
AU - Imazio, M.
AU - Lazaros, G.
AU - Picardi, E.
AU - Vasileiou, P.
AU - Orlando, F.
AU - Carraro, M.
AU - Tsiachris, D.
AU - Vlachopoulos, C.
AU - Georgiopoulos, G.
AU - Tousoulis, D.
AU - Belli, R.
AU - Gaita, F.
JO - British Heart Journal
PY - 2015
VL - 101
TODO - 18
SP - 1463-1467
PB - BMJ Publishing Group
SN - null
TODO - 10.1136/heartjnl-2014-307398
TODO - 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
TODO - 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.
ER -