Atrial fibrillation natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Natural history, complications and prognosis
Prognosis
The rate of ischemic stroke among nonrheumatic atrial fibrillation patients averages 5% per year, a rate that is between 2 and 7 times that of non-AF patients. One in every 6 strokes occurs in atrial fibrillation patients. The rate of brain ischemia in conjunction with nonvalvular atrial fibrillation exceeds 7% per year. Patients with both rheumatic heart disease and atrial fibrillation have an 17-fold risk increase when compared to age-matched controls and an attributable risk of 5 times greater than those with nonrheumatic atrial fibrillation. The Framingham Heart Study also found taht the annual risk of stroke attributable to atrial fibrillation increased from 1.5% in those aged 50-59 years to 23.5% for those aged 80-89 years. In the Manitoba Follow-up Study, atrial fibrillation doubled the risk of stroke independently of other risk factors. The relative risk for stroke in the Whitehall study was 6.99%. Relative risk in the Regional Heart study was 2.3%. In the ALFA study follow up, patients wwith atrial fibrillation were found to have a 2.4% incidence of thromboembolism with the mean being 8.6 months of follow-up time.[1]
The mortality rate of patients with atrial fibrillation is nearly double that of patients with normal sinus rhythm. This increase is linked to the severity of the underlying disease.[1]
References
- ↑ 1.0 1.1 Fuster V, Rydén LE, Cannom DS, Crijns HJ, Curtis AB, Ellenbogen KA et al. (2006) ACC/AHA/ESC 2006 Guidelines for the Management of Patients with Atrial Fibrillation: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and the European Society of Cardiology Committee for Practice Guidelines (Writing Committee to Revise the 2001 Guidelines for the Management of Patients With Atrial Fibrillation): developed in collaboration with the European Heart Rhythm Association and the Heart Rhythm Society. Circulation 114 (7):e257-354. DOI:10.1161/CIRCULATIONAHA.106.177292 PMID: 16908781