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Catheter Ablation in Combination With Left Atrial Appendage Closure for Atrial Fibrillation
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Atrial Fibrillation and Cardiovascular Outcomes in the Elderly

Wesley T O'Neal1, Taufiq Salahuddin2, Stephen T Broughton2

  • 1Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. wesley.oneal@emory.edu.

Pacing and Clinical Electrophysiology : PACE
|June 24, 2016
PubMed

Insights

Atrial fibrillation (AF) increases the risk of cardiovascular events, with heart failure being the most common outcome in elderly individuals. Managing risk factors may reduce AF-related morbidity and mortality.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Epidemiology

Background:

  • Limited data exist on the specific cardiovascular outcomes that most frequently affect elderly individuals with atrial fibrillation (AF).
  • Population-based studies are crucial for understanding the real-world incidence of AF-related complications in older adults.

Purpose of the Study:

  • To identify and quantify the incidence of major cardiovascular outcomes in elderly individuals with atrial fibrillation (AF).
  • To compare the frequency and risk of coronary heart disease (CHD), myocardial infarction (MI), heart failure, and ischemic stroke in individuals with and without AF.

Main Methods:

  • Analysis of 4,304 elderly participants from the Cardiovascular Health Study, free of baseline cardiovascular disease.
  • Identification of atrial fibrillation (AF) cases at baseline and as time-updated events.
  • Kaplan-Meier estimates and Cox regression to calculate cumulative incidence rates and hazard ratios (HR) for cardiovascular outcomes.

Main Results:

  • Individuals with AF exhibited higher cumulative incidence rates for CHD, MI, heart failure, and ischemic stroke compared to those without AF.
  • Heart failure was the most frequent cardiovascular outcome observed in participants with AF.
  • AF significantly increased the risk of heart failure (HR = 3.18), which was a greater association than for CHD, MI, or ischemic stroke.

Conclusions:

  • Atrial fibrillation (AF) is linked to a higher incidence of adverse cardiovascular outcomes, particularly heart failure, in the elderly population.
  • Targeted risk factor modification for primary prevention of heart failure may mitigate the significant morbidity and mortality associated with AF.
Abstract

Keywords:
atrial fibrillationepidemiologyoutcomes

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