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Arrythmia-induced cardiomyopathy: Characterization and outcomes of patients with rhythm or rate control in a population with complete sustained recovery of function.
Session:
Painel 4 -Arritmologia 1
Speaker:
João Grade Santos
Congress:
CPC 2020
Topic:
C. Arrhythmias and Device Therapy
Theme:
05. Atrial Fibrillation
Subtheme:
05.2 Atrial Fibrillation - Epidemiology, Prognosis, Outcome
Session Type:
Posters
FP Number:
---
Authors:
João Grade Santos; Otilia Ferreira Simões ; Paula Fazendas; Alexandra Briosa; Ana Rita F. Pereira; Ana I. Marques; Daniel Sebaiti; Sofia Alegria; Sofia Almeida; Helder Pereira
Abstract
<p><strong>Introduction: </strong>Arrhythmia-induced cardiomyopathy (AIC) is characterized by left ventricular systolic dysfunction caused by tachyarrhythmia, being atrial fibrillation (AF) the most common in clinical practice. The hallmark of AIC is its reversibility once the arrhythmia is properly controlled.</p> <p><strong>Purpose </strong>Our aim was to the evaluate the characteristics and outcomes of patients with confirmed AIC and complete sustained recovery of function.</p> <p><strong>Methods: </strong>Retrospective analysis was obtained of patients discharged from the Cardiology department of a tertiary hospital between 2011 and June 2016 with a confirmed diagnosis of AIC, either inward or during follow up, and sustained recovery of function at 1 and 5 years. Medical records were analysed for demographic and outcome data.</p> <p><strong>Results: </strong>Twenty four (24) patients fulfilled all inclusion criteria and were analysed. The mean age was 61 ± 11 years, with a male preponderance (75%) and an average body mass index (BMI) of 30,5 ± 1,57. Paroxysmal AF was identified in 58.3%; persistent AF in 29,2% and permanent AF was assumed in 12,5%. At admission, a severely compromised ejection fraction (EF) was identified in 54,2% vs 45,8% with moderately compromised EF.</p> <p>In 62,5% of patients a rhythm control strategy was used, either at admission or follow up (with 41.6% of patients undergoing electrical cardioversion and 16,7% chemical cardioversion), with 86% success rate. At 1 year 37,5% of patients remained in sinus rhythm (SR) (vs 54% at AF) and at 5 years 12,5% (vs 54% at AF). The remainders were lost to follow up.</p> <p>Comparing patients at one year who where in SR, we found that patients had significantly lower BMI (26,9 ± 2,36 vs 33,1 ± 1,81; T Student test p=0,04). We found no difference in age, sex or presence of comorbidities such as hypertension, diabetes mellitus, chronic kidney disease or lung disease in both groups.</p> <p>Furthermore patients in SR at 1 year had significantly higher EF (59, IQR 14 vs 48, IQR22; Mann Whitney U test p= 0,04).</p> <p>Regarding hospital admissions at 1 and 5 years we found no difference in sex, age or BMI. SR and EF, at admission and at 1 year, did not predict hospitalizations at 5 years.</p> <p><strong>Conclusion: </strong>In a population with AIC and complete sustained recovery of function, with a balanced distribution of maintenance of SR and rate control, a lower BMI predicted maintenance of sinus rhythm at year and these patients had higher EF than those in AF.</p>
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