Atrial Fibrillation in Chronic Aortic Regurgitation Linked to Increased Mortality Risk

METHODOLOGY:

Researchers conducted a retrospective cohort study to determine the prevalence and prognostic significance of AF in patients with hemodynamically significant aortic regurgitation.
The study included 1006 patients (mean age, 59 years; 82% men) with moderate-to-severe chronic aortic regurgitation between March 2004 and April 2019.
AF was identified using ECG and episodes were recorded by implanted cardiac devices.
The primary endpoint was all-cause mortality. Inclusion was halted for patients who received an aortic valve replacement.

AF was present in 16% of patients at the time of diagnosis of chronic aortic regurgitation. Those with AF were more likely to be older (adjusted odds ratio [aOR] per year increase, 1.06), men (aOR, 3.55), and have a diagnosis of congestive heart failure (aOR, 2.11; P ≤ .001 for all).
AF was independently associated with a significantly elevated risk for mortality in all three multivariable models even after adjusting for comorbid conditions and left ventricular systolic and diastolic function, with hazard ratios ranging from 1.61 to 2.21 (P < .05 for all).
Patients with AF had more severe symptoms and a higher risk for death than those with sinus rhythm (P < .05 for both).
The median duration between the diagnoses of AF and aortic regurgitation was 2.1 years, and AF was usually paroxysmal.

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