Idiopathic atrial fibrillation as a risk factor for mortality. The Paris Prospective Study I.

Area of Science:

• Cardiology
• Epidemiology
• Public Health

Background:

• Idiopathic atrial fibrillation (IAF) is defined as atrial fibrillation of unknown origin without underlying heart disease.
• Previous understanding suggested IAF did not significantly impact mortality rates.
• This study aimed to re-evaluate mortality risks associated with IAF using long-term follow-up data.

Purpose of the Study:

• To assess the long-term mortality associated with idiopathic atrial fibrillation in middle-aged men.
• To determine if IAF is an independent risk factor for mortality.
• To challenge the notion that IAF does not affect mortality.

Main Methods:

• Analysis of the Paris Prospective Study I data, including 6722 middle-aged French men (43-52 years) with an average follow-up of 23 years.
• Strict exclusion criteria were applied to identify cases of idiopathic atrial fibrillation, excluding individuals with known cardiac disease.
• Physical examinations, ECGs, questionnaires, and blood samples were collected at baseline.

Main Results:

• Twenty-five subjects were identified with idiopathic atrial fibrillation at baseline.
• IAF was associated with a 4.22-fold increased risk of cardiovascular mortality (P=0.0001) and a 1.97-fold increased risk of total mortality (P=0.01).
• IAF remained an independent risk factor for both cardiovascular and total mortality after adjusting for age, blood pressure, cholesterol, BMI, and smoking.

Conclusions:

• Idiopathic atrial fibrillation is associated with significantly higher cardiovascular and total mortality in middle-aged men.
• The findings indicate that IAF is a significant independent risk factor for mortality.
• This study necessitates a re-evaluation of the prognostic implications of idiopathic atrial fibrillation.