Τίτλος:
Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
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.
Συγγραφείς:
Imazio, M.
Lazaros, G.
Picardi, E.
Vasileiou, P.
Orlando, F.
Carraro, M.
Tsiachris, D.
Vlachopoulos, C.
Georgiopoulos, G.
Tousoulis, D.
Belli, R.
Gaita, F.
Περιοδικό:
British Heart Journal
Εκδότης:
BMJ Publishing Group
Λέξεις-κλειδιά:
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
DOI:
10.1136/heartjnl-2014-307398
