ATRIAL FIBRILLATION IN PATIENTS WITH SEVERE AORTIC STENOSIS

Atrial fibrillation occurs approximately in 5% patients with significant aortic stenosis. 

Aim of study: To determine prevalence of  atrial fibrillation  in patients with significant aortic stenosis. Other primary aim was to find clinical echocardiographic and hemodynamic predictors of atrial fibrillation.  Secondary aim :To analyze influence of arterial hypertension on occurrence of atrial fibrillation. Tertiary aim: To estimate significance of atrial fibrillation as a predictor of 48-month mortality.

Methods: Patients assigned to our study were reffered to the department of cardiology in the teaching hospital Na Bulovce in Prague in the interval from January 2004 to February 2008.  Patients involved in the database had aortic valve area ≤ 0.5 cm2/m2.

Results: Our group of patiens consisted of 204 persons with significant aortic stenosis ( 118 men and 86 woman. Average age was 72,2 years (woman  74,6, men  70,4 year/. Atrial fibrillation was present in 13.7% patients with significant aortic stenosis. It was insignificantly more common in woman than in men (17% vs. 11.2, p 0.23). The only independent predictor of atrial fibrillation was dilation of left atrium (p 0.001). Indexed  left ventricular mass  turned out to be of borderline significance (p 0.06) and  LVEF (p  0.07).  Atrial fibrillation was significantly more commonly associated with diuretic use ( OR 3.9  p 0,02, CI 1,13 – 13,4) Presence of atrial fibrillation increased insignificantly 2-year mortality.

 Conclusion: Atrial fibrillation belongs to the most common arrhythmias in patients with significant aortic stenosis. In our group of patients atrial fibrillation was present in 13.7% of patients. The only independent predictor of atrial fibrillation was dilatation of left atrium. Arterial hypertension did not have significant influence on the onset of atrial fibrillation