BACKGROUND: Little is known about the association of atrial fibrillation symptom burden with quality of life and outcomes. METHODS AND RESULTS: In the Prevention of Thromboembolic Events-European Registry in Atrial Fibrillation (n=6196 patients with atrial fibrillation; mean±SD age, 71.8±10.4 years; 39.7% women), we assessed European Heart Rhythm Association score symptoms and calculated correlations with the standardized health status questionnaire (EQ-5D-5L). Patients were followed up for atrial fibrillation therapies and outcomes (stroke/transient ischemic attack/arterial thromboembolism, coronary events, heart failure, and major bleeding) over 1 year. Most individuals (92%) experienced symptoms. Correlations with health status and quality of life were modest. In multivariable-adjusted regression models, the dichotomized European Heart Rhythm Association score (intermediate/frequent versus never/occasional symptoms) was associated with cardioversions (odds ratio [OR], 1.21; 95% confidence interval [CI], 1.01-1.45) and catheter ablation (OR, 1.97; 95% CI, 1.44-2.69), and inversely related with heart rate control (OR, 0.80; 95% CI, 0.70-0.92) and heart failure incidence (OR, 1.65; 95% CI, 1.16-2.34). Anxiety was inversely related with stroke/transient ischemic attack/arterial thromboembolism (OR, 0.55; 95% CI, 0.32-0.93), whereas chest pain related positively with coronary events (OR, 2.45; 95% CI, 1.42-4.22). Fatigue (OR, 1.84; 95% CI, 1.30-2.60), dyspnea (OR, 2.33; 95% CI, 1.63-3.33), and anxiety (OR, 1.72; 95% CI, 1.16-2.55) were associated with heart failure incidence. Palpitations were positively associated with cardioversion (OR, 1.32; 95% CI, 1.08-1.61) and ablation therapy (OR, 2.02; 95% CI, 1.48-2.76). CONCLUSIONS: A higher symptom burden, in particular palpitations, predicted interventions to restore sinus rhythm. The score itself had limited predictive value, but its individual components were related to different and specific clinical events, and may thus be helpful to target patient management.

• MeSH
• ablace MeSH
• časové faktory MeSH
• elektrická defibrilace MeSH
• fibrilace síní diagnóza   epidemiologie   patofyziologie   chirurgie   MeSH
• kvalita života * MeSH
• lidé středního věku MeSH
• lidé MeSH
• prediktivní hodnota testů MeSH
• prospektivní studie MeSH
• registrace MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční frekvence MeSH
• výsledek terapie MeSH
• zdravotní stav * MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• multicentrická studie MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH

OBJECTIVES: Determinants of atrial fibrillation (AF) patterns and of progression of earlier forms to permanent AF, and their relationship with outcome are still poorly understood. METHODS: We examined AF patterns (paroxysmal, persistent and permanent), rate and predictors of AF progression, and outcomes in the PREFER (PREvention oF thromboembolic events-European Registry) in AF. The primary analysis was performed in the PREFER in AF prolongation dataset (n=3223 patients with AF with a complete 1-year follow-up, mean age 72±9 years, 40% women). Sensitivity analyses were performed using the PREFER in the AF study (n=6390 patients). RESULTS: AF progressed to more persistent types in 506 patients (17%). Permanent AF was associated with development of heart failure at 1 year (OR 1.80, 95% CI 1.06 to 3.07, p=0.03) compared with paroxysmal AF, which was confirmed in the entire cohort. In multivariable-adjusted models, sinus rhythm at baseline, AF duration, cardioversion, hyperthyroidism, valvular heart disease, diabetes mellitus and heart failure were predictors of AF progression (area under the receiver operating characteristic curve 0.60, 95% CI 0.57 to 0.63). Results were similar when we restricted analyses to patients with AF duration <1 year. AF progression showed an association with coronary events over 1 year (OR 2.27, 95% CI 1.22 to 4.19, p=0.0074). CONCLUSIONS: Permanent AF at baseline was associated with incident heart failure. A substantial proportion of well-managed patients with AF showed AF progression over 1 year. AF progression itself was not strongly related to outcome and may indicate the need to refine the current classification of AF types to enhance clinical utility.

• MeSH
• diabetes mellitus diagnóza   epidemiologie   MeSH
• fibrilace síní * klasifikace   komplikace   diagnóza   epidemiologie   MeSH
• hodnocení výsledků zdravotní péče MeSH
• hypertyreóza diagnóza   epidemiologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• management péče o pacienta metody   MeSH
• nemoci srdečních chlopní diagnóza   epidemiologie   MeSH
• progrese nemoci * MeSH
• registrace statistika a číselné údaje   MeSH
• rizikové faktory MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• srdeční frekvence MeSH
• srdeční selhání diagnóza   epidemiologie   MeSH
• tromboembolie etiologie   prevence a kontrola   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• práce podpořená grantem MeSH
• Geografické názvy
• Evropa MeSH