Factors influencing mortality in atrial fibrillation. Post hoc analysis of an observational study in outpatients

Whether patients with atrial fibrillation (AF) have an increased mortality compared with the general population is controversially assessed.

The mortality of 409 outpatients with AF (36% female, mean age 62 years, 39% paroxysmal AF, 27% lone AF), who were included in a prospective observational study, was compared with the mortality of the general population.

The mortality was 4%/year and constant during the 10 years of follow-up. Age (p<0.0001), heart failure (p=0.0013) and echocardiographically detected reduced left ventricular systolic function (p=0.0353) were independent predictors. The mortality of AF patients was 1.4-fold higher than in the general population, of female 1.5 and of male 1.3. Patients with permanent AF had a 1.5-fold higher and patients with heart failure a 1.7-fold higher mortality than the general population. Patients with lone AF did not differ in the mortality from the general population. The mortality of AF patients was not influenced by the duration of atrial fibrillation.

The prognosis of AF patients is dependent on the cardiovascular co-morbidity, especially the presence or absence of heart failure.