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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
Published on: February 26, 2013
Is atrial fibrillation associated with pulmonary embolism?
1Division of General Internal Medicine, Geneva University Hospital, Geneva, Switzerland. gregoire.gex@hcuge.ch
Journal of Thrombosis and Haemostasis : JTH
|January 4, 2012
Summary
Atrial fibrillation (AF) does not increase the likelihood of pulmonary embolism (PE) when PE is suspected. However, AF may decrease PE probability if dyspnea is the primary symptom, but increase it if chest pain is the sole complaint.
Area of Science:
- Cardiology
- Pulmonology
- Medical Diagnostics
Background:
- Pulmonary embolism (PE) is often associated with atrial fibrillation (AF), but evidence is limited.
- Previous studies suggest a link, yet robust data is lacking.
Purpose of the Study:
- To determine if AF influences the clinical probability of PE in patients with suspected PE.
- To investigate the association between PE and AF.
Main Methods:
- Retrospective analysis of 2449 patients from two trials with suspected PE.
- Electrocardiography (ECG) and computed tomography (CT) were used for diagnosis.
- Multivariate logistic regression compared AF prevalence in PE patients.
Main Results:
- PE prevalence was 22.8% in patients without AF and 18.8% in patients with AF (P=0.28).
- AF did not significantly alter PE probability (OR 0.68, 95% CI 0.42-1.11) after adjustments.
- AF decreased PE probability with new-onset dyspnea (OR 0.47, 95% CI 0.26-0.84) but increased it with chest pain (OR 2.42, 95% CI 0.97-6.07).
Conclusions:
- Overall, AF presence does not elevate PE probability in suspected cases.
- AF significantly reduces PE probability when dyspnea is the presenting symptom, as AF can mimic dyspnea.
- In patients presenting with chest pain only, AF may increase the likelihood of PE.
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