[Impact of atrial fibrillation on prognosis of chronic heart failure patients with left ventricular ejection fraction>or=0.5].

OBJECTIVE

To explore the prevalence, distribution type and impact of atrial fibrillation on prognosis of hospitalized patients with congestive heart failure (CHF) with left ventricular ejection fraction (LVEF)>or=0.50.

METHODS

The medical records of 417 unselected consecutive patients with CHF were retrospectively reviewed. Patients were categorized as LVEF<0.50 or LVEF>or=0.50. And they were also categorized by the past history of atrial fibrillation and divided into three groups: paroxysmal atrial fibrillation, continuous atrial fibrillation and onset of atrial fibrillation after admission. Then the vicious events, the number of readmission due to CHF and the interval between discharge and readmission were observed and recorded.

RESULTS

Male patients were prevalent with CHF whose LVEF<0.50. The occurrence of acute myocardial infarction in the 1st year [15.6% (34/218)] was higher than that of CHF with LVEF>or=0.5 [8.0% (16/199), P<0.01]. The occurrence of cerebral stroke in patients with atrial fibrillation [24.3% (27/111)] was higher than that of patients without atrial fibrillation [8.4% (9/107), P<0.05). The numbers of acute coronary syndrome and cardiac death were also increased. In the patients with CHF whose LVEF>or=0.50 the incidence atrial fibrillation occurring after readmission was significantly higher than that of patient with CHF whose LVEF<0.50 (51 vs. 30, P<0.05). Atrial fibrillation could be found in nearly 2/3 of patients. And the number of readmission (2.78+/-1.79 vs. 2.00+/-1.35, P<0.01) was increased, while the interval between discharge and readmission [(117+/-107) days vs. (154+/-130) days, P<0.05] was shorter.

CONCLUSION

Atrial fibrillation occurs more likely in patients with CHF whose LVEF>or=0.50, leading to a shorter interval of readmission. Therefore the importance of treatment of atrial fibrillation should be emphasized.