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Predictors of primary atrial fibrillation and concomitant clinical and hemodynamic changes in patients with chronic heart failure: a prospective study in 344 patients with baseline sinus rhythm

Massimo Pozzoli, MD, FESC^a, Giovanni Cioffi, MD^*, Egidio Traversi, MD^a, Gian Domenico Pinna, MS^a, Franco Cobelli, MD^a and Luigi Tavazzi, MD, FESC, FACC

^a Salvatore Maugeri Foundation, Institute of Care and Research, Montescano Medical Center, Montescano, Pavia, Italy
^* Rehabilitation Center Eremo, Arco di Trento, Trento, Italy
Division of Cardiology, Policlinico San Matteo, Institute of Care and Research, Pavia, Italy

View larger version (18K): [in a new window]   Figure 1 Flowchart showing the occurrence of AF in 344 patients (pts) with SR during follow-up. Twenty-eight patients (8%) developed AF. AF persisted in 9 patients despite cardioversion, whereas SR was restored in 19 patients. SR persisted in 10 of these 19 patients throughout the follow-up, whereas AF occurred in the remaining 9, and SR could not be restored. Thus, overall, 18 patients (5%) developed chronic AF.

View larger version (27K): [in a new window]   Figure 2 Changes in New York Heart Association (NYHA) functional class in the 18 patients who developed chronic AF before and after the onset of AF.

View larger version (17K): [in a new window]   Figure 3 Changes in cardiac index over time in patients who later developed chronic AF (circles) versus those who remained in SR (squares).

View larger version (23K): [in a new window]   Figure 4 Changes in right and left atrial maximal volumes over time in patients who developed AF versus those who remained in SR.