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Characteristics of Asymptomatic Paroxysmal A-Fib Identified

WEDNESDAY, Jan. 31, 2018 -- For patients with paroxysmal atrial fibrillation (PAF), determinants of asymptomatic status have been identified, and mortality is increased for these patients, according to a study published in the December issue of CHEST.

Masahiro Esato, M.D., Ph.D., from Ijinkai Takeda General Hospital in Japan, and colleagues examined the clinical characteristics and outcomes of asymptomatic versus symptomatic patients with PAF (1,837 patients) and sustained AF (SAF; 1,912 patients) from the Fushimi AF Registry.

The researchers found that asymptomatic patients were older, more often male, and had a higher congestive heart failure, hypertension, age ≥75 years, diabetes mellitus, history of stroke, vascular disease, age 65 to 74 years, and female sex (CHAD2DS2-VASc) score in the PAF group; in the SAF group the prevalence of major comorbidities and CHA2DS2-VASc scores were comparable. In the PAF group, age (≥75 years), history of stroke/systemic embolism, male sex, and chronic kidney disease were independent determinants of asymptomatic status, in multivariate analysis; in the SAF group, age was nonsignificant. Compared with symptomatic patients, asymptomatic patients had significantly higher all-cause mortality in the PAF group (hazard ratio, 1.71); in the SAF group, all-cause mortality was comparable.

"Asymptomatic clinical status is associated with older age, male sex, more comorbidities with a higher stroke risk profile, and a higher incidence of all-cause death in patients with PAF; these characteristics and outcomes were not seen in the SAF group," the authors write.

The Fushimi AF Registry is supported by research funding from pharmaceutical companies.

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Posted: January 2018