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Updated: Apr 15, 2026

Estimating Bilateral Atrial Function by Cardiovascular Magnetic Resonance Feature Tracking in Patients with Paroxysmal Atrial Fibrillation
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Long-term prognostic impact of atrial fibrillation subtypes in unselected patients undergoing coronary angiography

Henning Johann Steffen1, Tobias Schupp1, Mohammad Abumayyaleh1

  • 1Cardiology, Haemostasis, and Medical Intensive Care, University Medical Centre Mannheim, Medical Faculty Mannheim, Heidelberg University.

Coronary Artery Disease
|April 14, 2026
PubMed

Insights

Atrial fibrillation significantly increases the risk of heart failure rehospitalization after coronary angiography, with permanent and persistent subtypes posing the highest long-term risk. This finding highlights the importance of managing atrial fibrillation in these patients.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Research

Background:

  • Atrial fibrillation (AF) is prevalent in patients undergoing coronary angiography.
  • Existing research links AF to adverse outcomes, but long-term prognosis and specific risks associated with AF subtypes, especially for heart failure, require further clarification.

Purpose of the Study:

  • To investigate the long-term prognostic implications of atrial fibrillation and its subtypes in patients undergoing coronary angiography.
  • To assess the impact of AF on heart failure risk and other cardiovascular outcomes.

Main Methods:

  • A cohort of 7529 patients undergoing coronary angiography (2016-2022) were analyzed.
  • Patients were stratified by AF status and subtype (paroxysmal, persistent, permanent, new-onset).
  • Primary endpoint: heart failure-related rehospitalization at 36 months; Secondary endpoints: coronary revascularization, acute myocardial infarction (AMI), and in-hospital mortality.

Main Results:

  • 26.8% of patients had AF, with new-onset AF being the most common subtype (31.0%).
  • AF patients were older and had higher rates of heart failure.
  • At 36 months, AF was independently associated with increased heart failure rehospitalization (HR=1.246), with risk increasing stepwise across subtypes: permanent (42.5%), persistent (34.8%), paroxysmal (26.9%), and new-onset (23.6%). AMI rates were similar, and revascularization rates were lower in AF patients.

Conclusions:

  • Atrial fibrillation is an independent predictor of long-term heart failure-related rehospitalization post-coronary angiography.
  • The risk of heart failure rehospitalization is highest in permanent and persistent AF subtypes.
  • These findings underscore the critical need for proactive management of AF in patients undergoing coronary angiography to mitigate heart failure risk.
Abstract

Keywords:
atrial fibrillationatrial fibrillation subtypescoronary angiographyheart failurerehospitalizationrisk stratification

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