Clinical research studyAsymptomatic Atrial Fibrillation: Clinical Correlates, Management, and Outcomes in the EORP-AF Pilot General Registry
Section snippets
Materials and Methods
The methods and baseline data from the EORP-AF Pilot General Registry have been published.18 Patients' enrollment started in early 2012. One-year follow-up phase (“pilot phase” or Phase 1) data were focused on the initial 3119 patients who were recruited for this database, collected from 9 countries, as a valid representative of ESC member countries.21
In brief, the registry population comprised consecutive inpatients and outpatients, enrolled in 67 centers in 9 countries, presenting with atrial
Results
A total of 3119 patients were enrolled, and at study entry 1237 (39.7%) were asymptomatic (EHRA score I). Among the 1882 patients who were symptomatic, 963 (51.2%) had mild symptoms (EHRA score II) and 919 (48.8%) had severe or disabling symptoms (EHRA III-IV) (Table 1). Compared with symptomatic atrial fibrillation at enrollment, asymptomatic atrial fibrillation was seen more commonly in patients in specialized centers (72.6% vs 59.4%, P < .0001) and outpatient clinics or private cardiology
Discussion
In this study, our principal findings are that (1) 40% of patients with atrial fibrillation are asymptomatic, and among those with symptoms, more than one half have mild symptoms (EHRA score II in 51.2%); and that (2) the prognostic implications of asymptomatic atrial fibrillation are evident by our data showing that asymptomatic atrial fibrillation is not benign but is associated with an even higher mortality at 1 year compared with symptomatic atrial fibrillation.
Asymptomatic atrial
Conclusions
Symptomatic atrial fibrillation is common in daily cardiology practice, but its management is challenging because it is associated with elderly age, more comorbidities, and high thromboembolic and hemorrhagic risks. A higher 1-year mortality was evident in patients with asymptomatic atrial fibrillation compared with patients with symptomatic atrial fibrillation.
Acknowledgments
Executive steering committee of the EORP-AF Pilot General Registry of the ESC: Gregory Y. H. Lip, Luigi Tavazzi, Aldo P. Maggioni, Harry J. G. M. Crijns, Paulus Kirchhof, and Panos Vardas.
Steering committee (national coordinators): Gheorghe-Andrei Dan, Dan Atar, Emmanuel Simantirakis, Massimo Santini, Zbigniew Kalarus, Lars Hvilsted Rasmussen, Mário Martins Oliveira, and Georges Mairesse.
Data monitor and technical support team: Data collection was conducted by the EORP Department from the ESC
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Funding: None.
Conflict of Interest: GB received a small speaker's fee from Boehringer, Medtronic Inc, and Boston Scientific. LHR is on the speakers bureaus for Bayer, BMS/Pfizer, Janssen Pharmaceuticals, Takeda, Roche Diagnostics, and Boehringer Ingelheim. LT is a consultant and speakers bureau member for Servier and a Committee Member for Servier, Medtronic Inc, St Jude Medical, CVIE Therapeutics, Boston Scientific, Vifor Pharma, and Cardiorentis. GYHL is a consultant for Bayer, Medtronic Inc, Sanofi, BMS/Pfizer, Daiichi-Sankyo, and Boehringer Ingelheim, and has been a speaker for Bayer, BMS/Pfizer, Boehringer Ingelheim, Daiichi-Sankyo, and Medtronic Inc. The remaining authors have no conflicts of interest associated with the work presented in this manuscript.
Authorship: All authors had access to the data and played a role in writing this manuscript.