New-onset Heart Failure With Atrial Fibrillation: A Distinct Type of Cardiomyopathy?

Area of Science:

• Cardiology
• Electrophysiology

Background:

• Atrial fibrillation (AF) is a common arrhythmia.
• Cardiomyopathy (CM) is a disease of the heart muscle.
• The relationship between new-onset CM and AF requires further investigation.

Purpose of the Study:

• To compare clinical characteristics and outcomes of patients with new-onset cardiomyopathy (CM) with and without atrial fibrillation (AF).
• To evaluate real-world treatment strategies for patients with CM and AF.

Main Methods:

• Retrospective analysis of patient records from January 2012 to September 2016.
• Inclusion criteria: left ventricular ejection fraction ≤40% and no prior history of CM.
• Comparison of two groups: new-onset CM with AF (AF-CM) and new-onset CM without dysrhythmia (CM).

Main Results:

• The AF-CM group (n=196) was older, more male, had more comorbidities, lower cardiac biomarkers, and lower ECG voltage than the CM group (n=197).
• AF-CM patients often presented with atypical symptoms and had higher mortality.
• Rhythm control procedures (ablation/cardioversion) were infrequent, especially in women, older patients, and those with coronary artery disease.

Conclusions:

• New-onset CM associated with AF presents distinct demographic, clinical, and outcome profiles compared to CM without AF.
• Real-world treatment predominantly favors medical management over rhythm control strategies for AF-CM.