The interplay between atrial fibrillation and heart failure on long-term mortality and length of stay: Insights from the, United Kingdom ACALM registry. (1st February 2018)

• Record Type: Journal Article
• Authors: Ziff, Oliver J.; Carter, Paul R.; McGowan, John; Uppal, Hardeep; Chandran, Suresh; Russell, Stuart; Bainey, Kevin R.; Potluri, Rahul
• Is Part Of: International journal of cardiology. Volume 252(2018)
• Page Start: 117
• Page End: 121
• Publication Date: 2018-02-01
• Subjects: Atrial fibrillation -- Mortality -- Heart failure -- Hospitalisation -- Length of stay; Cardiology -- Periodicals; Electronic journals; 616.12
• DOI: 10.1016/j.ijcard.2017.06.033
• Languages: English
• ISSNs: 0167-5273

Abstract

Abstract: Background: There is concern that the development of heart failure and atrial fibrillation has a detrimental influence on clinical outcomes. The aim of this study was to assess all-cause mortality and length of hospital stay in patients with chronic and new-onset concomitant AF and HF. Methods: Using the ACALM registry, we analysed adults hospitalised between 2000 and 2013 with AF and HF and assessed prevalence, mortality and length of hospital stay. Patients with HF and/or AF at baseline (study-entry) were compared with patients who developed new-onset disease during follow-up. Results: Of 929, 552 patients, 31, 695 (3.4%) were in AF without HF, 20, 768 (2.2%) had HF in sinus rhythm, and 10, 992 (1.2%) had HF in AF. Patients with HF in AF had the greatest all-cause mortality (70.8%), followed by HF in sinus rhythm (64.1%) and AF alone (45.1%, p < 0.0001). Patients that developed new-onset AF, HF or both had significantly worse mortality (58.5%, 70.7% and 74.8% respectively) compared to those already with the condition at baseline (48.5%, 63.7% and 67.2% respectively, p < 0.0001). Patients with HF in AF had the longest length of hospital stay (9.41 days, 95% CI 8.90–9.92), followed by HF in sinus rhythm (7.67, 95% CI 7.34–8.00) and AF alone (6.05, 95% CI 5.78–6.31). Conclusions: Patients with HF in AF are at a greater risk of mortality and longer hospital stay compared to patients without the combination. New-onset AF or HF is associated with significantly worse prognosis than long-standing disease.