Migotanie przedsionków – Rokowania, prognozy i postęp choroby

Migotanie przedsionków
Rokowania, prognozy i postęp choroby

Migotanie przedsionków (MP) jest najczęstszą utrwaloną arytmią serca, dotykającą około 2,7 miliona Amerykanów, i stanowi istotny czynnik ryzyka udaru mózgu, niewydolności serca oraz zwiększonej śmiertelności. Udar związany z MP jest cięższy, częściej prowadzi do niepełnosprawności i ma wyższe wskaźniki śmiertelności niż udar niezwiązany z tą arytmią. Systemy oceny ryzyka, takie jak CHADS₂ i rozszerzony CHA₂DS₂-VASc, są powszechnie stosowane do przewidywania ryzyka udaru, a nowoczesne modele oparte na uczeniu maszynowym (np. FIND-AF) poprawiają dokładność predykcji krótkoterminowego ryzyka MP. U pacjentów z niewydolnością serca obecność MP podwaja ryzyko zgonu, a pooperacyjne MP wiąże się z wyższą śmiertelnością, którą można częściowo zmniejszyć stosując antykoagulację. Metaanalizy wskazują na wyższe ryzyko powikłań u pacjentów z utrwalonym MP w porównaniu do napadowego, choć korelacje te mogą ulec zmianie po uwzględnieniu zmiennych czasowych.

Prognostyka migotania przedsionków

Migotanie przedsionków (MP) jest najczęstszą utrwaloną arytmią serca, dotykającą szacunkowo 2,7 miliona Amerykanów, a w skali globalnej stanowiącą istotny problem zdrowotny o rosnącym znaczeniu dla zdrowia publicznego.¹² Jego występowanie wiąże się ze zwiększonym ryzykiem udaru mózgu, niewydolności serca oraz zgonu, co ma daleko idące implikacje dla zdrowia publicznego.³ Prognostyka pacjentów z migotaniem przedsionków jest złożona i zależy od wielu czynników, w tym wieku, chorób współistniejących oraz stosowanego leczenia.⁴

Czynniki ryzyka zdarzeń niepożądanych

Migotanie przedsionków jest niezależnym czynnikiem ryzyka predysponującym do udaru mózgu, przyczyniając się istotnie do zwiększonej śmiertelności.⁵ Wysoki stopień zachorowalności związanej z udarami wtórnymi do migotania przedsionków wynika prawdopodobnie z czterech czynników:

zakrzepowo-zatorowego charakteru incydentów naczyniowo-mózgowych
związku między migotaniem przedsionków a innymi chorobami układu sercowo-naczyniowego
predylekcji udarów związanych z migotaniem przedsionków do zajmowania krążenia przedniego lub prowadzenia do wielu ognisk niedokrwiennych
ustalonych związków między migotaniem przedsionków a stanami prozapalnymi i nadkrzepliwością⁶

Niedawne badania podkreślają, że nawet do 21% pacjentów z udarem mózgu lub przemijającymi atakami niedokrwiennymi ma niezdiagnozowane migotanie przedsionków.⁷ Dodatkowo, w porównaniu do udaru niedokrwiennego niezwiązanego z migotaniem przedsionków, udar związany z tą arytmią jest zazwyczaj bardziej ciężki, powoduje większą niepełnosprawność, wyższą śmiertelność i generuje wyższe koszty.⁸ Pacjenci ci są zwykle starsi, a zmiany najczęściej powodują rozleglejsze uszkodzenia tkanek i zazwyczaj występują w obszarze unaczynienia tętnicy środkowej mózgu.⁹

Skale ryzyka i modele predykcyjne

System oceny ryzyka CHADS₂ (Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled]) jest najszerzej stosowanym algorytmem do przewidywania udaru mózgu w migotaniu przedsionków.¹⁰ Rozszerzony system CHA₂DS₂-VASc został opracowany, aby uwzględnić zarówno główne kliniczne czynniki ryzyka, jak i istotne klinicznie czynniki drugorzędne w zaktualizowanym schemacie przewidywania ryzyka udaru.¹¹

Nowe modele predykcyjne, takie jak FIND-AF (Future Innovations in Novel Detection of Atrial Fibrillation), oparte na algorytmach uczenia maszynowego, umożliwiają dokładniejsze przewidywanie ryzyka wystąpienia migotania przedsionków w krótkim okresie (6 miesięcy). Model ten wykazuje lepszą dokładność predykcyjną niż inne skale ryzyka i jest skuteczny zarówno u mężczyzn, jak i kobiet oraz w różnych grupach etnicznych.¹²¹³ Co istotne, krótkoterminowe przewidywane ryzyko migotania przedsionków przekłada się również na długoterminowe występowanie tej arytmii.¹⁴

Dla pacjentów z przetrwałym migotaniem przedsionków poddawanych ablacji opracowano skalę FLAME (Female, Long-lasting, Atrial diameter, Mitral, Extreme), która jest pierwszym narzędziem predykcyjnym koncentrującym się wyłącznie na populacji z migotaniem przedsionków innym niż napadowe. Skala ta skutecznie stratyfikuje wyniki zarówno pierwszej, jak i wielokrotnych ablacji cewnikowych.¹⁵¹⁶

Prognostyka w grupach szczególnego ryzyka

Migotanie przedsionków a niewydolność serca

Badania wskazują, że obecność migotania przedsionków u pacjentów z niewydolnością serca wiąże się z ponad 2-krotnie wyższym ryzykiem zgonu w porównaniu do pacjentów z samą niewydolnością serca. Co więcej, pacjenci, u których migotanie przedsionków rozwinęło się po zdiagnozowaniu niewydolności serca, znajdują się w grupie większego ryzyka zgonu niż pacjenci z wcześniej istniejącym migotaniem przedsionków w momencie diagnozy niewydolności serca.¹⁷

Należy zauważyć, że w niektórych przypadkach, gdy migotanie przedsionków powoduje zwiększoną częstość akcji serca przez dłuższy czas (zwykle tygodnie), może to prowadzić do osłabienia pracy serca i niewydolności serca. To osłabienie jest zwykle odwracalne, o ile można zmniejszyć częstość akcji serca, przywracając w ten sposób normalną funkcję serca.¹⁸

Migotanie przedsionków a zawał mięśnia sercowego

Niedawne badanie kohortowe oparte na społeczności potwierdziło wyniki kilku wcześniejszych badań, wykazując, że migotanie przedsionków było związane z 4-krotnie wyższym ryzykiem zgonu u pacjentów z zawałem mięśnia sercowego w porównaniu do pacjentów bez migotania przedsionków.¹⁹

Migotanie przedsionków a przewlekła choroba nerek

Przewlekła choroba nerek jest zarówno głównym czynnikiem ryzyka rozwoju migotania przedsionków, jak i czynnikiem ryzyka udaru mózgu.²⁰ Badania wykazały, że przewlekła choroba nerek wiąże się z wyższym ryzykiem zdarzeń zakrzepowo-zatorowych w migotaniu przedsionków po skorygowaniu o inne istotne czynniki ryzyka.²¹

Migotanie przedsionków a ryzyko operacyjne

Badanie van Diepena i wsp. obejmujące ponad 38 000 pacjentów wykazało, że 6,4% pacjentów z migotaniem przedsionków, którzy przeszli zabieg operacyjny niekardiochirurgiczny, zmarło w ciągu 30 dni od operacji, a pacjenci z migotaniem przedsionków mieli o 69% wyższe ryzyko śmiertelności pooperacyjnej niż pacjenci z chorobą wieńcową serca.²²

Związek między pooperacyjnym migotaniem przedsionków a ryzykiem zgonu był złagodzony, gdy pacjentom przepisano warfarynę, co sugeruje, że pooperacyjne migotanie przedsionków było związane z późniejszymi powikłaniami zakrzepowo-zatorowymi wtórnymi do epizodów migotania przedsionków.²³

Nowe badania wskazują również, że nowo rozpoznane pooperacyjne migotanie przedsionków (nPOAF) jest częstym powikłaniem po operacji kardiochirurgicznej (30-50%) i wiąże się z niekorzystnymi wynikami zarówno w krótkim, jak i długim okresie, w tym z wyższym ryzykiem udaru mózgu, przedłużonym pobytem w szpitalu i obciążeniem zasobów szpitalnych.²⁴

Wpływ typu migotania przedsionków na prognozę

Dyskusyjne jest, w jakim stopniu typ migotania przedsionków wpływa na ryzyko zdarzeń niepożądanych. Niedawna metaanaliza wykazała wyższe ryzyko zatorowości i zgonu u pacjentów z migotaniem przedsionków innym niż napadowe w porównaniu do pacjentów z napadowym migotaniem przedsionków podczas 1-2,8 lat obserwacji.²⁵

W dużym badaniu dobrze leczonych pacjentów z migotaniem przedsionków, częstość występowania udaru/zatorowości systemowej (SE) wśród pacjentów z utrwalonym migotaniem przedsionków była prawie dwukrotnie wyższa w porównaniu z pacjentami z napadowym migotaniem przedsionków. Jednak w modelach skorygowanych ze zmiennymi zmieniającymi się w czasie, przetrwałe i utrwalone migotanie przedsionków nie były istotnie związane z udarem/SE.²⁶²⁷

Narzędzia do prognozowania z wykorzystaniem zaawansowanych technologii

Rozwijane są coraz bardziej zaawansowane narzędzia do prognozowania oparte na sztucznej inteligencji i uczeniu maszynowym. Modele te mogą uwzględniać nie tylko dane kliniczne, ale również dane z elektrokardiogramów (EKG) czy obrazowania serca.

Analizując przedoperacyjne informacje z elektrokardiogramu powierzchniowego, badacze badali trzy aspekty: dominującą częstotliwość przedsionkową (DAF), powtarzalność wzorca w aktywności przedsionkowej poprzez entropię próbki (SampEn) oraz średnią moc fal migotania (fWP). Wszystkie te parametry wykazały znaczną zdolność prognostyczną na poziomie odpowiednio 68,97%, 72,42% i 75,86%. Dodatkowo, połączenie tych parametrów poprzez drzewo decyzyjne znacznie poprawiło dokładność prognozy do 82,76%, z czułością 81,25% i swoistością 84,62%.²⁸

W niedawnym badaniu zidentyfikowano płeć męską, podwyższone poziomy lipoproteiny(a) [Lp(a)], hemoglobiny glikowanej (HbA1c), stosunku neutrofili do limfocytów (NLR) oraz indeksu triglicerydowo-glukozowego (TyG) jako niezależne czynniki ryzyka rozwoju migotania przedsionków. Model wykazał zarówno doskonałą kalibrację (test Hosmera-Lemeshowa, P>0,05), jak i użyteczność kliniczną, przy czym wszystkie włączone zmienne są łatwo dostępne i ekonomiczne dla rutynowych badań przesiewowych ryzyka migotania przedsionków w populacjach z nadciśnieniem tętniczym.²⁹³⁰

Badacze analizowali również, czy nawroty migotania przedsionków po ablacji mogą być przewidywane poprzez ocenę wzorców epizodów. W badaniu oceniono ryzyko nawrotu migotania przedsionków po ablacji cewnikowej z użyciem parametrów Hawkes log(mu) i beta1, obciążenia migotaniem przedsionków oraz gęstości migotania przedsionków. Parametry Hawkes wykazały zwiększone ryzyko nawrotu migotania przedsionków w ciągu 1 roku po zabiegu dla pacjentów z wysoką dominacją migotania przedsionków i wysoką agregacją epizodów i mogą być używane do oceny ryzyka przedablacyjnego.³¹

Wpływ leczenia na prognozę

Prawidłowo leczone migotanie przedsionków generalnie ma dobrą prognozę, a pacjenci mogą prowadzić normalne życie.³² Wdrożenie odpowiedniego leczenia oraz regularne wizyty kontrolne u lekarza zazwyczaj poprawiają rokowanie pacjentów z migotaniem przedsionków. Według American Heart Association (AHA), 35% osób, które nie otrzymają leczenia z powodu migotania przedsionków, doświadcza udaru mózgu.³³

AHA zauważa, że epizod migotania przedsionków rzadko powoduje śmierć. Jednak epizody te mogą przyczynić się do wystąpienia innych powikłań, takich jak udar mózgu i niewydolność serca, które mogą prowadzić do śmierci.³⁴

Większość osób w wieku 65 lat i starszych z migotaniem przedsionków przyjmuje leki przeciwzakrzepowe, aby zmniejszyć prawdopodobieństwo powikłań, takich jak udar mózgu. To poprawia ogólną prognozę dla osób z migotaniem przedsionków.³⁵

Roczne ryzyko nawrotu udaru niedokrwiennego u pacjentów z migotaniem przedsionków bez doustnego leczenia przeciwzakrzepowego było znacznie wysokie we wczesnych badaniach, nawet u pacjentów z nielicznymi chorobami współistniejącymi. Ryzyko rocznego nawrotu sugerowano na poziomie do 10%, nawet u pacjentów z migotaniem przedsionków przyjmujących leki przeciwzakrzepowe, a śmiertelność do 50% w ciągu 2 lat po pierwszym udarze.³⁶

Różnice w rokowaniu w zależności od czynników ryzyka

Nie wszyscy pacjenci z migotaniem przedsionków mają takie samo ryzyko udaru mózgu. U mniej niż 1 na 100 pacjentów z migotaniem przedsionków o niskim ryzyku wystąpi udar każdego roku. Spośród osób z wysokim ryzykiem, u ponad 10 na 100 wystąpi udar każdego roku.³⁷

Wiele czynników wpływa na rokowanie w migotaniu przedsionków, w tym wiek, stan zdrowia i przyjmowane leki. Jeśli pacjent ma schorzenie takie jak cukrzyca, otyłość lub wysokie ciśnienie krwi, jego rokowanie może być gorsze niż u osoby, która nie ma innych problemów zdrowotnych.³⁸

Migotanie przedsionków zwiększa ryzyko przedwczesnej śmierci. Niewydolność serca i udar mózgu są dwiema głównymi przyczynami śmierci u osób z migotaniem przedsionków. Jednak dzięki ulepszonym metodom leczenia, ogólna liczba zgonów z powodu migotania przedsionków zmniejszyła się.³⁹

Mimo postępów w leczeniu migotania przedsionków, rokowanie pacjentów z tą arytmią, szczególnie u rosnącej liczby osób zarówno z migotaniem przedsionków, jak i niewydolnością serca, pozostaje niekorzystne.⁴⁰ Potrzebne są dalsze badania, aby ustalić, czy ukierunkowanie interwencji profilaktyki pierwotnej i wtórnej na takich pacjentów, być może poprzez wykorzystanie markerów prognostycznych, poprawia rokowanie w migotaniu przedsionków.⁴¹

Znaczenie wczesnego wykrywania migotania przedsionków

Istnieje uzasadnienie dla wczesnej diagnozy migotania przedsionków, zanim wystąpi pierwsze powikłanie, jednak nie zaleca się badań przesiewowych populacyjnych.⁴² Wczesna diagnoza migotania przedsionków, przed manifestacją pierwszego powikłania, pozostaje głównym wyzwaniem dla zdrowia publicznego.⁴³

Modele predykcyjne mogą przyczynić się do badań przesiewowych migotania przedsionków poprzez rozróżnienie pacjentów na kategorie ryzyka, na podstawie których można zaplanować intensywność badań.⁴⁴ Model predykcyjny, który może zidentyfikować w środowisku społeczności, którzy pacjenci rozwiną migotanie przedsionków i kiedy najprawdopodobniej to nastąpi, mógłby umożliwić ukierunkowane badania przesiewowe.⁴⁵

Im dłuższe badania przesiewowe i im wcześniejszy czas po ostrym udarze niedokrwiennym, tym większe prawdopodobieństwo wykrycia napadu migotania przedsionków.⁴⁶

Indywidualizacja prognozy

Nie istnieją statystyki dotyczące oczekiwanej długości życia dla osób z migotaniem przedsionków. W celu uzyskania spersonalizowanej prognozy, należy zapytać lekarza, czego można się spodziewać i jakie leczenie oraz zmiany stylu życia mogą pomóc. Ćwiczenia, utrata wagi, zdrowe odżywianie oraz leczenie, takie jak leki przeciwzakrzepowe i leki obniżające ciśnienie krwi, mogą pomóc pacjentowi żyć dłużej i lepiej z migotaniem przedsionków.⁴⁷

Krótko mówiąc, migotanie przedsionków może wpłynąć na długość życia pacjenta. Reprezentuje ono dysfunkcję serca, którą należy leczyć. Jednak dostępnych jest wiele metod leczenia, które mogą pomóc kontrolować objawy i zmniejszyć ryzyko poważnych zdarzeń, takich jak udar mózgu i niewydolność serca.⁴⁸

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Materiały źródłowe

#1 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Atrial fibrillation (AF) is a highly prevalent and costly health problem, with an estimated incidence of 28 per 1000 person-years in the U.S. and an incremental national cost of $26 billion. […] The growing burden of AF has far-reaching public health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. […] In recent years, the prognosis of patients with AF in certain at-risk subgroups, including those with heart failure, myocardial infarction, and chronic kidney disease, has been studied. […] Non-rheumatic AF is a major contributor to increased mortality rates and an independent risk factor predisposing to stroke. […] The high degree of morbidity from strokes secondary to AF likely relates to 4 factors: 1) the thromboembolic nature of AF-related cerebrovascular events; 2) the association between AF and other cardiovascular diseases; 3) the predilection for strokes from AF to involve the anterior circulation or lead to multiple ischemic foci; 4) and the established associations between AF and pro-inflammatory and hypercoagulable states.
#2 Atrial Fibrillation (AFib): Whatâs My Prognosis?
https://www.healthline.com/health/atrial-fibrillation-prognosis
According to Johns Hopkins Medicine, an estimated 2.7 million Americans have AFib. As many as one-fifth of all people who have a stroke also have AFib. […] Most people ages 65 and older who have AFib also take blood-thinning medications to reduce the likelihood of complications like stroke. This improves overall prognosis for people with AFib. […] Seeking treatment and maintaining regular visits with your doctor can typically improve your prognosis when you have AFib. According to the American Heart Association (AHA), 35 percent of people who don’t receive treatment for AFib go on to have a stroke. […] The AHA notes that an episode of AFib rarely causes death. However, these episodes can contribute to you experiencing other complications, such as stroke and heart failure, that can lead to death.
#3 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Atrial fibrillation (AF) is a highly prevalent and costly health problem, with an estimated incidence of 28 per 1000 person-years in the U.S. and an incremental national cost of $26 billion. […] The growing burden of AF has far-reaching public health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. […] In recent years, the prognosis of patients with AF in certain at-risk subgroups, including those with heart failure, myocardial infarction, and chronic kidney disease, has been studied. […] Non-rheumatic AF is a major contributor to increased mortality rates and an independent risk factor predisposing to stroke. […] The high degree of morbidity from strokes secondary to AF likely relates to 4 factors: 1) the thromboembolic nature of AF-related cerebrovascular events; 2) the association between AF and other cardiovascular diseases; 3) the predilection for strokes from AF to involve the anterior circulation or lead to multiple ischemic foci; 4) and the established associations between AF and pro-inflammatory and hypercoagulable states.
#4 Atrial Fibrillation: Prognosis, Life Expectancy
https://www.webmd.com/heart-disease/atrial-fibrillation/atrial-fibrillation-prognosis-life-expectancy
When your doctor diagnoses you with atrial fibrillation (AFib), you might wonder what to expect. Your prognosis is a prediction of how your disease could affect you in the future and how long you might live. […] Untreated AFib can raise your risk for problems like a heart attack, stroke, and heart failure, which could shorten your life expectancy. But treatments and lifestyle changes can help prevent these problems and manage your risks. […] Many things affect your AFib prognosis, including your age, health, and what medicines you take. […] If you have a health condition like diabetes, obesity, or high blood pressure, your outcome may be worse than someone who doesn’t have other health issues. […] AFib does raise the risk of dying early. Heart failure and stroke are two of the main causes of death in people with AFib. But with improved treatments, overall deaths from AFib have dropped.
#5 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Atrial fibrillation (AF) is a highly prevalent and costly health problem, with an estimated incidence of 28 per 1000 person-years in the U.S. and an incremental national cost of $26 billion. […] The growing burden of AF has far-reaching public health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. […] In recent years, the prognosis of patients with AF in certain at-risk subgroups, including those with heart failure, myocardial infarction, and chronic kidney disease, has been studied. […] Non-rheumatic AF is a major contributor to increased mortality rates and an independent risk factor predisposing to stroke. […] The high degree of morbidity from strokes secondary to AF likely relates to 4 factors: 1) the thromboembolic nature of AF-related cerebrovascular events; 2) the association between AF and other cardiovascular diseases; 3) the predilection for strokes from AF to involve the anterior circulation or lead to multiple ischemic foci; 4) and the established associations between AF and pro-inflammatory and hypercoagulable states.
#6 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Atrial fibrillation (AF) is a highly prevalent and costly health problem, with an estimated incidence of 28 per 1000 person-years in the U.S. and an incremental national cost of $26 billion. […] The growing burden of AF has far-reaching public health implications due to the association of AF with an increased risk of stroke, heart failure, and mortality. […] In recent years, the prognosis of patients with AF in certain at-risk subgroups, including those with heart failure, myocardial infarction, and chronic kidney disease, has been studied. […] Non-rheumatic AF is a major contributor to increased mortality rates and an independent risk factor predisposing to stroke. […] The high degree of morbidity from strokes secondary to AF likely relates to 4 factors: 1) the thromboembolic nature of AF-related cerebrovascular events; 2) the association between AF and other cardiovascular diseases; 3) the predilection for strokes from AF to involve the anterior circulation or lead to multiple ischemic foci; 4) and the established associations between AF and pro-inflammatory and hypercoagulable states.
#7 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Recent studies, in some cases using implantable electrocardiographic monitors, have emphasized that up to 21% of patients with stroke or transient ischemic attacks have undiagnosed AF. […] The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled; CHADS2] risk scoring system is the most widely used algorithm to predict stroke. […] The CHA2DS2-VASc risk score was developed to incorporate both major clinical risk factors and clinically relevant non-major risk factors into an updated clinical stroke risk prediction schema. […] The association between post-operative AF and risk for dying was attenuated when patients were prescribed warfarin, suggesting that postoperative AF was associated with subsequent thromboembolic complications secondary to episodes of AF. […] A recent study by van Diepen et al. involving over 38,000 patients showed that 6.4% of patients with AF who underwent a non-cardiac surgical procedure died within 30 days of their operation and that patients with AF had a 69% higher risk for post-operative mortality than patients with coronary heart disease.
#8 Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis
https://www.mdpi.com/2077-0383/13/1/30
Atrial fibrillation (AF) is the most common sustained arrhythmia and one of the strongest risk factors and causal mechanisms of ischemic stroke (IS). […] Patients with treated AF have reported to experience worse outcomes after endovascular treatment compared with patients without AF. […] The longer the screening and the earlier the time point after acute IS, the more likely the AF paroxysm is found. […] The annual risk of recurrent IS in AF patients without OAC was considerably high in early studies, even in patients with few comorbidities. […] The risk of annual recurrence has been suggested to be up 10%, even in anticoagulated AF patients, and the mortality up to 50% within 2 years after the index stroke. […] Compared to non-AF IS, IS associated with AF is likely to be more severe and cause greater disability, fatality, and costs.
#9 Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis
https://www.mdpi.com/2077-0383/13/1/30
These patients are usually older and AF-associated IS most commonly causes larger tissue damage and tends to present in the middle cerebral artery territory. […] In a recent systematic review and meta-analysis including patients with AF and acute IS, patients with AF and large vessel occlusion experienced worse 90-day outcomes and higher mortality compared to those without AF, even in the setting of similar rates of successful reperfusion.
#10 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Recent studies, in some cases using implantable electrocardiographic monitors, have emphasized that up to 21% of patients with stroke or transient ischemic attacks have undiagnosed AF. […] The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled; CHADS2] risk scoring system is the most widely used algorithm to predict stroke. […] The CHA2DS2-VASc risk score was developed to incorporate both major clinical risk factors and clinically relevant non-major risk factors into an updated clinical stroke risk prediction schema. […] The association between post-operative AF and risk for dying was attenuated when patients were prescribed warfarin, suggesting that postoperative AF was associated with subsequent thromboembolic complications secondary to episodes of AF. […] A recent study by van Diepen et al. involving over 38,000 patients showed that 6.4% of patients with AF who underwent a non-cardiac surgical procedure died within 30 days of their operation and that patients with AF had a 69% higher risk for post-operative mortality than patients with coronary heart disease.
#11 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Recent studies, in some cases using implantable electrocardiographic monitors, have emphasized that up to 21% of patients with stroke or transient ischemic attacks have undiagnosed AF. […] The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled; CHADS2] risk scoring system is the most widely used algorithm to predict stroke. […] The CHA2DS2-VASc risk score was developed to incorporate both major clinical risk factors and clinically relevant non-major risk factors into an updated clinical stroke risk prediction schema. […] The association between post-operative AF and risk for dying was attenuated when patients were prescribed warfarin, suggesting that postoperative AF was associated with subsequent thromboembolic complications secondary to episodes of AF. […] A recent study by van Diepen et al. involving over 38,000 patients showed that 6.4% of patients with AF who underwent a non-cardiac surgical procedure died within 30 days of their operation and that patients with AF had a 69% higher risk for post-operative mortality than patients with coronary heart disease.
#12 Prediction of short-term atrial fibrillation risk using primary care electronic health records | Heart
https://heart.bmj.com/content/109/14/1072
Objective Atrial fibrillation (AF) screening by age achieves a low yield and misses younger individuals. We aimed to develop an algorithm in nationwide routinely collected primary care data to predict the risk of incident AF within 6 months (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)). […] FIND-AF, a machine learning algorithm applicable at scale in routinely collected primary care data, identifies people at higher risk of short-term AF. […] In this nationwide primary care EHR study, we show that a random forest classifier (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) can be used to accurately predict AF risk within 6 months, superior to the C2HEST and CHA2DS2-VASc scores, and can be applied to all UK primary care EHRs. […] Higher predicted AF risk was also associated with increased long-term AF occurrence. Within 5 and 10 years, respectively, 5.1% and 11.9% of the higher predicted risk cohort had been diagnosed with AF, with an 8.75-fold increased hazard (95% CI 8.44 to 9.06) relative to individuals at lower predicted risk.
#13 Prediction of short-term atrial fibrillation risk using primary care electronic health records | Heart
https://heart.bmj.com/content/109/14/1072
FIND-AF demonstrated good predictive accuracy, which was superior to other risk scores and robust in both sexes and across ethnic groups. FIND-AF identified a cohort of younger people at higher risk of AF and more efficiently identified individuals diagnosed with AF within 6 months compared with age-based risk stratification. Finally, short-term predicted AF risk also translated to long-term AF occurrence.
#14 Prediction of short-term atrial fibrillation risk using primary care electronic health records | Heart
https://heart.bmj.com/content/109/14/1072
Objective Atrial fibrillation (AF) screening by age achieves a low yield and misses younger individuals. We aimed to develop an algorithm in nationwide routinely collected primary care data to predict the risk of incident AF within 6 months (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)). […] FIND-AF, a machine learning algorithm applicable at scale in routinely collected primary care data, identifies people at higher risk of short-term AF. […] In this nationwide primary care EHR study, we show that a random forest classifier (Future Innovations in Novel Detection of Atrial Fibrillation (FIND-AF)) can be used to accurately predict AF risk within 6 months, superior to the C2HEST and CHA2DS2-VASc scores, and can be applied to all UK primary care EHRs. […] Higher predicted AF risk was also associated with increased long-term AF occurrence. Within 5 and 10 years, respectively, 5.1% and 11.9% of the higher predicted risk cohort had been diagnosed with AF, with an 8.75-fold increased hazard (95% CI 8.44 to 9.06) relative to individuals at lower predicted risk.
#15 Internationally validated score to predict the outcome of non-paroxysmal atrial fibrillation ablation: the âFLAME scoreâ | Open Heart
https://openheart.bmj.com/content/8/2/e001653
The clinical effectiveness of ablating non-paroxysmal atrial fibrillation (non-PAF) relies on proper patient selection. We developed and validated a scoring system to predict non-PAF ablation outcomes. […] The FLAME score was applied to data (882 non-PAF ablations) at a Californian centre, and predicted the outcome of both single (p0.0001) and multiple (p0.0001) procedures. […] FLAME score is easily calculated, derived in London, and predicted single and multiple procedural outcomes for non-PAF ablations in California. In patients with a high score, even multiple procedures are usually ineffective. […] The Female, Long-lasting, Atrial diameter, Mitral, Extreme score is the first outcome prediction tool focusing only on the non-PAF population undergoing catheter ablation. […] The score can stratify patients both for first and multiprocedural outcomes after catheter ablation.
#16 Internationally validated score to predict the outcome of non-paroxysmal atrial fibrillation ablation: the âFLAME scoreâ | Open Heart
https://openheart.bmj.com/content/8/2/e001653
The FLAME score, easily calculated from baseline clinical variables, was derived from an analysis of individual procedural outcomes of catheter ablation for persistent AF in London. It effectively stratified the outcomes of first or multiple catheter ablations for persistent AF in California. Such a score may help to better advise individual patients about the effectiveness of catheter ablation for non-PAF.
#17 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The findings of a recent community-based study involving 1664 individuals with heart failure showed not only that the presence of AF was associated with a greater than 2-fold higher risk of death compared to those with heart failure alone, but also that patients with AF developing after heart failure were at greater risk for dying than patients with pre-existing AF at the time of heart failure diagnosis. […] A recent community-based cohort study confirmed the findings of several prior investigations, showing that AF was associated with a four-fold higher risk for death in patients with myocardial infarction when compared to those with no AF. […] Chronic kidney disease is both a major risk factor for the development of AF as well as risk for stroke. […] These findings demonstrate that chronic kidney disease is associated with a higher risk of thromboembolic events in AF after adjustment for other relevant risk factors.
#18 Prognosis for Atrial Fibrillation | PortalCLÃNIC
https://www.clinicbarcelona.org/en/assistance/diseases/atrial-fibrillation/evolution-of-the-disease
When treated correctly, atrial fibrillation generally has a good prognosis and patients can live a normal life. […] Not everybody with atrial fibrillation has the same risk of suffering a stroke. Less than 1 in every 100 patients with low-risk atrial fibrillation will endure a stroke each year. Of those with a high risk, more than 10 in every 100 will suffer a stroke each year. […] Heart failure is a weakening of the heart. In some cases where atrial fibrillation results in an increased heart rate for extended periods, generally weeks, then this situation can weaken the heart. This weakening is usually reversible so long as the heart rate can be reduced, thereby re-establishing normal heart function.
#19 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The findings of a recent community-based study involving 1664 individuals with heart failure showed not only that the presence of AF was associated with a greater than 2-fold higher risk of death compared to those with heart failure alone, but also that patients with AF developing after heart failure were at greater risk for dying than patients with pre-existing AF at the time of heart failure diagnosis. […] A recent community-based cohort study confirmed the findings of several prior investigations, showing that AF was associated with a four-fold higher risk for death in patients with myocardial infarction when compared to those with no AF. […] Chronic kidney disease is both a major risk factor for the development of AF as well as risk for stroke. […] These findings demonstrate that chronic kidney disease is associated with a higher risk of thromboembolic events in AF after adjustment for other relevant risk factors.
#20 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The findings of a recent community-based study involving 1664 individuals with heart failure showed not only that the presence of AF was associated with a greater than 2-fold higher risk of death compared to those with heart failure alone, but also that patients with AF developing after heart failure were at greater risk for dying than patients with pre-existing AF at the time of heart failure diagnosis. […] A recent community-based cohort study confirmed the findings of several prior investigations, showing that AF was associated with a four-fold higher risk for death in patients with myocardial infarction when compared to those with no AF. […] Chronic kidney disease is both a major risk factor for the development of AF as well as risk for stroke. […] These findings demonstrate that chronic kidney disease is associated with a higher risk of thromboembolic events in AF after adjustment for other relevant risk factors.
#21 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The findings of a recent community-based study involving 1664 individuals with heart failure showed not only that the presence of AF was associated with a greater than 2-fold higher risk of death compared to those with heart failure alone, but also that patients with AF developing after heart failure were at greater risk for dying than patients with pre-existing AF at the time of heart failure diagnosis. […] A recent community-based cohort study confirmed the findings of several prior investigations, showing that AF was associated with a four-fold higher risk for death in patients with myocardial infarction when compared to those with no AF. […] Chronic kidney disease is both a major risk factor for the development of AF as well as risk for stroke. […] These findings demonstrate that chronic kidney disease is associated with a higher risk of thromboembolic events in AF after adjustment for other relevant risk factors.
#22 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Recent studies, in some cases using implantable electrocardiographic monitors, have emphasized that up to 21% of patients with stroke or transient ischemic attacks have undiagnosed AF. […] The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled; CHADS2] risk scoring system is the most widely used algorithm to predict stroke. […] The CHA2DS2-VASc risk score was developed to incorporate both major clinical risk factors and clinically relevant non-major risk factors into an updated clinical stroke risk prediction schema. […] The association between post-operative AF and risk for dying was attenuated when patients were prescribed warfarin, suggesting that postoperative AF was associated with subsequent thromboembolic complications secondary to episodes of AF. […] A recent study by van Diepen et al. involving over 38,000 patients showed that 6.4% of patients with AF who underwent a non-cardiac surgical procedure died within 30 days of their operation and that patients with AF had a 69% higher risk for post-operative mortality than patients with coronary heart disease.
#23 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
Recent studies, in some cases using implantable electrocardiographic monitors, have emphasized that up to 21% of patients with stroke or transient ischemic attacks have undiagnosed AF. […] The Cardiac failure, Hypertension, Age, Diabetes, Stroke [Doubled; CHADS2] risk scoring system is the most widely used algorithm to predict stroke. […] The CHA2DS2-VASc risk score was developed to incorporate both major clinical risk factors and clinically relevant non-major risk factors into an updated clinical stroke risk prediction schema. […] The association between post-operative AF and risk for dying was attenuated when patients were prescribed warfarin, suggesting that postoperative AF was associated with subsequent thromboembolic complications secondary to episodes of AF. […] A recent study by van Diepen et al. involving over 38,000 patients showed that 6.4% of patients with AF who underwent a non-cardiac surgical procedure died within 30 days of their operation and that patients with AF had a 69% higher risk for post-operative mortality than patients with coronary heart disease.
#24 Machine learning-based prediction of new onset of atrial fibrillation after mitral valve surgery | International Journal of Arrhythmia | Full Text
https://arrhythmia.biomedcentral.com/articles/10.1186/s42444-024-00127-4
New-onset postoperative atrial fibrillation (nPOAF) is a common complication after cardiac surgery (30-50%), being associated with unfavorable long-term outcomes. […] It is associated with unfavorable near-term and long-term outcomes, including a higher risk of stroke, prolonged hospital length of stay, and strained hospital resources. […] Predicting nPOAF and its short-term sequelae following MV surgery remains highly challenging. Machine learning methods offer a moderate degree of improvement in predicting nPOAF even in large national-level studies, in the absence of multi-modal data, such as real-time wearables data, electrocardiograms, heart rhythm monitoring, or cardiac imaging. […] Predicting the occurrence of POAF using machine learning methods remains challenging for multiple reasons. This study of STS ACS national registry data suggests that a further expansion of multi-modal real-time data sources may improve POAF prediction.
#25 Long-term risk of adverse outcomes according to atrial fibrillation type | Scientific Reports
https://www.nature.com/articles/s41598-022-05688-9
Sustained forms of atrial fibrillation (AF) may be associated with a higher risk of adverse outcomes, but few if any long-term studies took into account changes of AF type and co-morbidities over time. […] In this large prospective cohort of AF patients, time-updated AF type was not associated with incident stroke/SE. […] To what extent the risk of these and other outcome events is influenced by AF type is still debated. […] A recent meta-analysis found a higher risk of thromboembolism and death in patients with non-paroxysmal AF than in patients with paroxysmal AF during 1 to 2.8 years of follow-up. […] In this large study of well-treated patients with AF, the incidence rate of stroke/SE among patients with time-updated permanent AF was almost twice as high compared with patients with paroxysmal AF.
#26 Long-term risk of adverse outcomes according to atrial fibrillation type | Scientific Reports
https://www.nature.com/articles/s41598-022-05688-9
Sustained forms of atrial fibrillation (AF) may be associated with a higher risk of adverse outcomes, but few if any long-term studies took into account changes of AF type and co-morbidities over time. […] In this large prospective cohort of AF patients, time-updated AF type was not associated with incident stroke/SE. […] To what extent the risk of these and other outcome events is influenced by AF type is still debated. […] A recent meta-analysis found a higher risk of thromboembolism and death in patients with non-paroxysmal AF than in patients with paroxysmal AF during 1 to 2.8 years of follow-up. […] In this large study of well-treated patients with AF, the incidence rate of stroke/SE among patients with time-updated permanent AF was almost twice as high compared with patients with paroxysmal AF.
#27 Long-term risk of adverse outcomes according to atrial fibrillation type | Scientific Reports
https://www.nature.com/articles/s41598-022-05688-9
In adjusted models with time-varying covariates, time-updated persistent and permanent AF were not significantly associated with stroke/SE. […] While time-updated AF type remained significantly associated with all-cause mortality and CHF hospitalizations, taking into account co-morbidities and risk factors attenuated these results.
#28 Preoperative Prognosis of Atrial Fibrillation Concomitant Surgery Outcome after the Blanking Period | SpringerLink
https://link.springer.com/chapter/10.1007/978-3-319-00846-2_463
Despite recent advances in the treatment of atrial fibrillation (AF), Cox-Maze surgery still is the therapy with the highest success rate. Long-term outcome prediction of this procedure has been widely studied in previous works. However, only few studies addressed the short-time prediction issue. Moreover, they all presented a very limited predictive ability. In the present work, preoperative information from the surface electrocardiogram (ECG) is analyzed to predict the patients rhythm after the blanking period, which lasts 3 months after the surgery. Three aspects have been studied: the dominant atrial frequency (DAF), the pattern repetitiveness in the atrial activity via sample entropy (SampEn) and the fibrillatory waves mean power (fWP). They all revealed a considerably high prognosis ability of 68.97%, 72.42% and 75.86%, respectively. Additionally, the combination of these parameters through a decision tree improved substantially the prognosis accuracy up to 82.76%, with sensitivity of 81.25% and specificity of 84.62%. Hence, the preoperative ECG can yield clinically relevant information on the patients rhythm after the blanking period and could be helpful in the development of tailored postoperative therapies.
#29 Clinical prediction study on the risk of atrial fibrillation in hypertensive patients based on metabolism, inflammation, and gender differences | Scientific Reports
https://www.nature.com/articles/s41598-025-97965-6
This study aimed to explore the risk factors for atrial fibrillation (AF) within one year after discharge in hypertensive patients and to construct a corresponding predictive model. […] Patients who developed AF within one year had significantly higher levels of white blood cells (WBC), neutrophils (NEUT), lymphocytes (LYMPH), creatinine (Scr), fasting blood glucose (FBG), triglycerides (TG), lipoprotein(a) [Lp(a)], glycated hemoglobin (HbA1c), neutrophil-to-lymphocyte ratio (NLR), and triglyceride-glucose (TyG) index compared to those who did not (P0.05). […] Logistic regression analysis showed that male gender, Lp(a), HbA1c, NLR, and the TyG index were independent predictors of AF within one year after discharge in hypertensive patients. […] Male, Lp(a), HbA1c, NLR, and the TyG index are independent risk factors for AF within one year of discharge in hypertensive patients.
#30 Clinical prediction study on the risk of atrial fibrillation in hypertensive patients based on metabolism, inflammation, and gender differences | Scientific Reports
https://www.nature.com/articles/s41598-025-97965-6
In this study, we identified male sex, elevated Lp(a), HbA1c, NLR, and TyG index as independent risk factors for AF development. […] The model exhibited both excellent calibration (HosmerLemeshow test, P0.05) and clinical utility, with all incorporated variables being readily accessible and cost-effective for routine AF risk screening in hypertensive populations. […] Therefore, identifying risk factors for AF within the first year after discharge and providing early intervention could significantly improve patient prognosis and quality of life. […] Male sex, Lp(a), HbA1c, NLR, and the TyG index are independent risk factors for AF within one year after discharge in hypertensive patients. The use of these indicators may provide strong support for post-discharge risk assessment, potentially improving long-term outcomes for patients.
#31
https://link.springer.com/article/10.1007/s11517-022-02713-x
Metody charakteryzacji wzorcÃ³w epizodÃ³w migotania przedsionkÃ³w (AF) zostaÅy wprowadzone bez ustalenia znaczenia klinicznego. […] To badanie bada, po raz pierwszy, czy nawroty AF po ablacji mogÄ byÄ przewidywane poprzez ocenÄ wzorcÃ³w epizodÃ³w. […] Ryzyko nawrotu AF po ablacji katetrowej z uÅ¼yciem parametrÃ³w Hawkes log(mu) i beta1, obciÄÅ¼enia AF oraz gÄstoÅci AF zostaÅo ocenione. […] PoÅÄczenie log(mu) i beta1 jest zwiÄzane z hazard ratio wynoszÄcym 1.95 (1.03-3.70; p<0.05). [...] Parametry Hawkes wykazaÅy zwiÄkszone ryzyko nawrotu AF w ciÄgu 1 roku po zabiegu dla pacjentÃ³w z wysokÄ dominacjÄ AF i wysokÄ agregacjÄ epizodÃ³w i mogÄ byÄ uÅ¼ywane do oceny ryzyka przedablacyjnego. [...] PoÅÄczenie obciÄÅ¼enia AF i gÄstoÅci AF jest zwiÄzane z nieistotnym hazard ratio, [...] W analizie dwuparametrowej, poÅÄczenie log(mu) i beta1 jest zwiÄzane z wyÅ¼szym ryzykiem wczesnego nawrotu AF z hazard ratio wynoszÄcym 1.95 (95% CI, 1.03-3.70; p<0.05).
#32 Prognosis for Atrial Fibrillation | PortalCLÃNIC
https://www.clinicbarcelona.org/en/assistance/diseases/atrial-fibrillation/evolution-of-the-disease
When treated correctly, atrial fibrillation generally has a good prognosis and patients can live a normal life. […] Not everybody with atrial fibrillation has the same risk of suffering a stroke. Less than 1 in every 100 patients with low-risk atrial fibrillation will endure a stroke each year. Of those with a high risk, more than 10 in every 100 will suffer a stroke each year. […] Heart failure is a weakening of the heart. In some cases where atrial fibrillation results in an increased heart rate for extended periods, generally weeks, then this situation can weaken the heart. This weakening is usually reversible so long as the heart rate can be reduced, thereby re-establishing normal heart function.
#33 Atrial Fibrillation (AFib): Whatâs My Prognosis?
https://www.healthline.com/health/atrial-fibrillation-prognosis
According to Johns Hopkins Medicine, an estimated 2.7 million Americans have AFib. As many as one-fifth of all people who have a stroke also have AFib. […] Most people ages 65 and older who have AFib also take blood-thinning medications to reduce the likelihood of complications like stroke. This improves overall prognosis for people with AFib. […] Seeking treatment and maintaining regular visits with your doctor can typically improve your prognosis when you have AFib. According to the American Heart Association (AHA), 35 percent of people who don’t receive treatment for AFib go on to have a stroke. […] The AHA notes that an episode of AFib rarely causes death. However, these episodes can contribute to you experiencing other complications, such as stroke and heart failure, that can lead to death.
#34 Atrial Fibrillation (AFib): Whatâs My Prognosis?
https://www.healthline.com/health/atrial-fibrillation-prognosis
According to Johns Hopkins Medicine, an estimated 2.7 million Americans have AFib. As many as one-fifth of all people who have a stroke also have AFib. […] Most people ages 65 and older who have AFib also take blood-thinning medications to reduce the likelihood of complications like stroke. This improves overall prognosis for people with AFib. […] Seeking treatment and maintaining regular visits with your doctor can typically improve your prognosis when you have AFib. According to the American Heart Association (AHA), 35 percent of people who don’t receive treatment for AFib go on to have a stroke. […] The AHA notes that an episode of AFib rarely causes death. However, these episodes can contribute to you experiencing other complications, such as stroke and heart failure, that can lead to death.
#35 Atrial Fibrillation (AFib): Whatâs My Prognosis?
https://www.healthline.com/health/atrial-fibrillation-prognosis
According to Johns Hopkins Medicine, an estimated 2.7 million Americans have AFib. As many as one-fifth of all people who have a stroke also have AFib. […] Most people ages 65 and older who have AFib also take blood-thinning medications to reduce the likelihood of complications like stroke. This improves overall prognosis for people with AFib. […] Seeking treatment and maintaining regular visits with your doctor can typically improve your prognosis when you have AFib. According to the American Heart Association (AHA), 35 percent of people who don’t receive treatment for AFib go on to have a stroke. […] The AHA notes that an episode of AFib rarely causes death. However, these episodes can contribute to you experiencing other complications, such as stroke and heart failure, that can lead to death.
#36 Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis
https://www.mdpi.com/2077-0383/13/1/30
Atrial fibrillation (AF) is the most common sustained arrhythmia and one of the strongest risk factors and causal mechanisms of ischemic stroke (IS). […] Patients with treated AF have reported to experience worse outcomes after endovascular treatment compared with patients without AF. […] The longer the screening and the earlier the time point after acute IS, the more likely the AF paroxysm is found. […] The annual risk of recurrent IS in AF patients without OAC was considerably high in early studies, even in patients with few comorbidities. […] The risk of annual recurrence has been suggested to be up 10%, even in anticoagulated AF patients, and the mortality up to 50% within 2 years after the index stroke. […] Compared to non-AF IS, IS associated with AF is likely to be more severe and cause greater disability, fatality, and costs.
#37 Prognosis for Atrial Fibrillation | PortalCLÃNIC
https://www.clinicbarcelona.org/en/assistance/diseases/atrial-fibrillation/evolution-of-the-disease
When treated correctly, atrial fibrillation generally has a good prognosis and patients can live a normal life. […] Not everybody with atrial fibrillation has the same risk of suffering a stroke. Less than 1 in every 100 patients with low-risk atrial fibrillation will endure a stroke each year. Of those with a high risk, more than 10 in every 100 will suffer a stroke each year. […] Heart failure is a weakening of the heart. In some cases where atrial fibrillation results in an increased heart rate for extended periods, generally weeks, then this situation can weaken the heart. This weakening is usually reversible so long as the heart rate can be reduced, thereby re-establishing normal heart function.
#38 Atrial Fibrillation: Prognosis, Life Expectancy
https://www.webmd.com/heart-disease/atrial-fibrillation/atrial-fibrillation-prognosis-life-expectancy
When your doctor diagnoses you with atrial fibrillation (AFib), you might wonder what to expect. Your prognosis is a prediction of how your disease could affect you in the future and how long you might live. […] Untreated AFib can raise your risk for problems like a heart attack, stroke, and heart failure, which could shorten your life expectancy. But treatments and lifestyle changes can help prevent these problems and manage your risks. […] Many things affect your AFib prognosis, including your age, health, and what medicines you take. […] If you have a health condition like diabetes, obesity, or high blood pressure, your outcome may be worse than someone who doesn’t have other health issues. […] AFib does raise the risk of dying early. Heart failure and stroke are two of the main causes of death in people with AFib. But with improved treatments, overall deaths from AFib have dropped.
#39 Atrial Fibrillation: Prognosis, Life Expectancy
https://www.webmd.com/heart-disease/atrial-fibrillation/atrial-fibrillation-prognosis-life-expectancy
When your doctor diagnoses you with atrial fibrillation (AFib), you might wonder what to expect. Your prognosis is a prediction of how your disease could affect you in the future and how long you might live. […] Untreated AFib can raise your risk for problems like a heart attack, stroke, and heart failure, which could shorten your life expectancy. But treatments and lifestyle changes can help prevent these problems and manage your risks. […] Many things affect your AFib prognosis, including your age, health, and what medicines you take. […] If you have a health condition like diabetes, obesity, or high blood pressure, your outcome may be worse than someone who doesn’t have other health issues. […] AFib does raise the risk of dying early. Heart failure and stroke are two of the main causes of death in people with AFib. But with improved treatments, overall deaths from AFib have dropped.
#40 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The prognosis of patients with AF, particularly the increasing number of individuals with both AF and heart failure, remains poor despite advances in the treatment of AF. […] Future research is needed to determine whether targeting of primary and secondary prevention interventions on such patients, perhaps through the use of prognostic markers, improves prognosis from AF.
#41 An Update on the Prognosis of Patients with Atrial Fibrillation
https://pmc.ncbi.nlm.nih.gov/articles/PMC3678907/
The prognosis of patients with AF, particularly the increasing number of individuals with both AF and heart failure, remains poor despite advances in the treatment of AF. […] Future research is needed to determine whether targeting of primary and secondary prevention interventions on such patients, perhaps through the use of prognostic markers, improves prognosis from AF.
#42 Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
https://pmc.ncbi.nlm.nih.gov/articles/PMC8565546/
Atrial fibrillation (AF) is a major cardiovascular health problem: it is common, chronic and incurs substantial healthcare expenditure because of stroke. […] There is a rationale for the early diagnosis of AF, before the first complication occurs, but population-based screening is not recommended. […] The model will not just predict the risk of a patient developing atrial fibrillation, but also provide a representation of how risk develops over time to enable more focused screening. […] Thus, the early diagnosis of AF, before the manifestation of the first complication, remains a major public health challenge. […] Prediction models could contribute to AF screening by discriminating patients into risk categories, from which investigation intensity could be planned. […] A systematic review found that the models derived from prospective cohorts had been more frequently externally validated.
#43 Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
https://pmc.ncbi.nlm.nih.gov/articles/PMC8565546/
Atrial fibrillation (AF) is a major cardiovascular health problem: it is common, chronic and incurs substantial healthcare expenditure because of stroke. […] There is a rationale for the early diagnosis of AF, before the first complication occurs, but population-based screening is not recommended. […] The model will not just predict the risk of a patient developing atrial fibrillation, but also provide a representation of how risk develops over time to enable more focused screening. […] Thus, the early diagnosis of AF, before the manifestation of the first complication, remains a major public health challenge. […] Prediction models could contribute to AF screening by discriminating patients into risk categories, from which investigation intensity could be planned. […] A systematic review found that the models derived from prospective cohorts had been more frequently externally validated.
#44 Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
https://pmc.ncbi.nlm.nih.gov/articles/PMC8565546/
Atrial fibrillation (AF) is a major cardiovascular health problem: it is common, chronic and incurs substantial healthcare expenditure because of stroke. […] There is a rationale for the early diagnosis of AF, before the first complication occurs, but population-based screening is not recommended. […] The model will not just predict the risk of a patient developing atrial fibrillation, but also provide a representation of how risk develops over time to enable more focused screening. […] Thus, the early diagnosis of AF, before the manifestation of the first complication, remains a major public health challenge. […] Prediction models could contribute to AF screening by discriminating patients into risk categories, from which investigation intensity could be planned. […] A systematic review found that the models derived from prospective cohorts had been more frequently externally validated.
#45 Predicting patient-level new-onset atrial fibrillation from population-based nationwide electronic health records: protocol of FIND-AF for developing a precision medicine prediction model using artificial intelligence
https://pmc.ncbi.nlm.nih.gov/articles/PMC8565546/
Each model to date is, however, limited by one or more of their use of small, geographically remote or historical datasets, lack of temporal information, crude risk modelling with consequent suboptimal model performance and/or predictor variables not readily available in primary care. […] A recent study applying this methodology to a nationwide UK dataset produced a model with a greater discriminative capability than CHARGE-AF (area under receiver operating characteristic (AUC) 0.827 vs 0.725) in EHR. […] A prediction model that may identify in a community setting which individuals will develop AF, and when this is most likely to occur, could enable targeted screening.
#46 Stroke in Patients with Atrial Fibrillation: Epidemiology, Screening, and Prognosis
https://www.mdpi.com/2077-0383/13/1/30
Atrial fibrillation (AF) is the most common sustained arrhythmia and one of the strongest risk factors and causal mechanisms of ischemic stroke (IS). […] Patients with treated AF have reported to experience worse outcomes after endovascular treatment compared with patients without AF. […] The longer the screening and the earlier the time point after acute IS, the more likely the AF paroxysm is found. […] The annual risk of recurrent IS in AF patients without OAC was considerably high in early studies, even in patients with few comorbidities. […] The risk of annual recurrence has been suggested to be up 10%, even in anticoagulated AF patients, and the mortality up to 50% within 2 years after the index stroke. […] Compared to non-AF IS, IS associated with AF is likely to be more severe and cause greater disability, fatality, and costs.
#47 Atrial Fibrillation: Prognosis, Life Expectancy
https://www.webmd.com/heart-disease/atrial-fibrillation/atrial-fibrillation-prognosis-life-expectancy
There arent life expectancy statistics for people with AFib. For a personalized prognosis, ask your doctor what you can expect and what treatments and lifestyle changes can help. Exercise, weight loss, healthy eating, and treatments like blood thinners and blood pressure medicines might help you live longer — and better — with AFib.
#48 Atrial Fibrillation (AFib): Whatâs My Prognosis?
https://www.healthline.com/health/atrial-fibrillation-prognosis
In short, it’s possible for AFib to affect your lifespan. It represents a dysfunction in the heart that must be addressed. However, many treatments are available that can help you control your symptoms and reduce your risk for major events, such as stroke and heart failure. […] It’s possible to follow all these steps and not prevent AFib. However, a healthy lifestyle will enhance your overall health and prognosis if you have AFib.