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The Prevalence and Impact of Atrial Fibrillation on Patients with Chronic Total Occlusions: Insights from the

Maximilian Will1,2,3, Konstantin Schwarz1,2, Eric Holroyd4,5

  • 1Karl Landsteiner University of Health Sciences, Dr. Karl-Dorrek-Straße 30, 3500 Krems, Austria.

Journal of Cardiovascular Development and Disease
|March 26, 2025
PubMed

Insights

Atrial fibrillation (AF) in patients with chronic total occlusions (CTOs) is linked to worse in-hospital outcomes. This includes higher mortality, stroke, bleeding, longer hospital stays, and increased costs for CTO patients with AF.

Area of Science:

  • Cardiology
  • Internal Medicine
  • Public Health

Background:

  • Atrial fibrillation (AF) is a common arrhythmia, and chronic total occlusions (CTOs) represent a significant challenge in cardiovascular care.
  • The combined impact of AF and CTOs on patient outcomes at a national level requires further investigation.

Purpose of the Study:

  • To analyze the characteristics of patients with CTOs and atrial fibrillation (AF).
  • To evaluate the in-hospital outcomes, including mortality, length of stay, and costs, for patients with CTOs, comparing those with and without AF.

Main Methods:

  • Retrospective analysis of the National Inpatient Sample database.
  • Inclusion of 480,180 patients diagnosed with CTO.
  • Logistic and linear regression models to assess factors associated with AF and its impact on outcomes.

Main Results:

  • AF was present in 28.0% of CTO patients, who were older and had more comorbidities like heart failure, liver disease, and obesity.
  • AF was significantly associated with increased in-hospital mortality (OR 1.29), ischemic stroke (OR 1.27), and major bleeding (OR 1.38).
  • Patients with AF experienced longer length of stay (coef 1.58) and higher in-hospital costs (coef 6.22).

Conclusions:

  • Atrial fibrillation is associated with poorer in-hospital outcomes in patients with chronic total occlusions.
  • These findings highlight the importance of managing AF in CTO patients to mitigate adverse events and reduce healthcare resource utilization.

Keywords:
atrial fibrillationchronic total occlusionischemic strokemajor bleedingmortality

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