Int J Arrhythm.
2020 Mar;21(1):e1. 10.1186/s42444-019-0009-9.
Characteristics of symptom burden in atrial fibrillation with concomitant heart failure
- Heo R1
- Cha M2
- Kim T3
- Lee J4
- Park J5
- Park H6
- Kang K7
- Shim J8
- Uhm J3
- Kim J9
- Kim J3
- Kim C10
- Lee Y11
- Choi E2
- Joung B3
- Park J
1
- Affiliations
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- 1Department of Cardiology, Hanyang University Medical Center, Han‑ yang University Seoul Hospital, 222‑1 Wangsimri Road, Seongdong‑gu, Seoul 04763, Republic of Korea
- 2Department of Internal Medicine, Seoul National University Hospital, Seoul, Republic of Korea
- 3Division of Cardiology, Department of Internal Medicine, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Republic of Korea
- 4Division of Cardiology, Department of Internal Medicine, Kyung Hee University Hospital, Kyung Hee University, Seoul, Republic of Korea
- 5Department of Cardiology, School of Medicine, Ewha Womans University, Seoul, Republic of Korea
- 6Department of Cardiology, Chonnam National University Hospital, Chonnam National University School of Medicine, Gwangju, Republic of Korea
- 7Division of Cardiology, Eulji University Hospital, Daejeon, Republic of Korea
- 8Division of Cardiology, Department of Internal Medicine, Korea University Medical Center, Seoul, Republic of Korea
- 9Heart Institute, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- 10Department of Preventive Medicine, Institute of Human Complexity and Systems Science, Yonsei University College of Medicine, Seoul, Korea
- 11Division of Cardiology, Department of Internal Medicine, Daegu Catholic University Medical Center, Daegu, Republic of Korea
- KMID: 2507213
- DOI: http://doi.org/10.1186/s42444-019-0009-9
Abstract
- Background
Symptom burden is an important factor in determining the treatment of atrial fibrillation (AF). AF is frequently accompanied by heart failure (HF). This study investigated the characteristics of AF symptoms with concomitant HF.
Methods
A total of 4885 patients with AF were consecutively enrolled through a prospective observational registry (the Comparison Study of Drugs for Symptom Control and Complication Prevention of Atrial Fibrillation [CODE-AF] registry). Clinically diagnosed HF was divided into three categories (preserved, mid-range, and reduced ejection fraction [EF]). Symptom severity was assessed using the European Heart Rhythm Association (EHRA) classification.
Results
The presence of AF-related symptoms was comparable irrespective of concomitant HF. Patients with HF with reduced EF demonstrated severe (EHRA classes 3 and 4) and atypical symptoms. HF with preserved EF was also associated with atypical symptoms. Female sex and AF type were associated with the presence of symptoms in AF without HF, and non-maintenance of sinus rhythm and increased left atrial pressure (E/e′ ≥ 15) were factors related to the presence of symptoms in AF with HF.
Conclusion
AF with concomitant HF presented with more severe and atypical symptoms than AF without HF. Maintaining the sinus rhythm and reducing the E/e’ ratio are important factors for reducing symptoms in AF with concomitant HF.
