Monday, 1 September 2008 - European Heart Journal

292 Atrial fibrillation
Results: LA ejection fraction and fractional shortening were significantly decreased
in PAF. However, LA dimension, A-wave of transmitral flow, and LA emptying
volume were comparable between two groups. The parameters of atrial
dyssynchrony were summarized in Table.
Table 1. Atrial dyssynchrony
Control
Reservoir period
PAF p-value
Ts-SD 16.0±11.4 19.2±15.0 0.258
Tst-SD 29.7±11.9 39.7±15.8 0.001
Tsr-SD
Atrial contraction period
37.3±18.7 41.8±14.1 0.262
Ts-SD 25.9±16.3 33.6±18.6 0.035
Tsr-SD 29.5±14.1 36.9±17.1 0.084
Conclusions: In patients with recent onset PAF, atrial dyssynchrony was present.
Of all parameters, dyssynchronous atrial lengthening assessed by strain during
reservoir period showed the greatest difference between two groups.
P1921 Predictors of mortality in atrial fibrillation
T. Potpara1 ,M.Grujic2 ,J.Marinkovic2 , B. Vujisic2 ,N.Mujovic2 ,
M. Polovina2 . 1Institute for Cardiovascular Diseases, cardiology,
Belgrade, Serbia; 2Institute for Cardiovascular Diseases,KCS,
Belgrade, Serbia
The aim of the study was to assess mortality of patients treated for atrial fibrillation
(AF).
Out of 1100 pts with recently diagnosed AF, aged 52.7±12.0 years, 389 pts
(35.4%) were females, 442 pts (40.2%) had lone AF, 939 pts (85.4%) had normal
left ventricular systolic function and 33 pts (3.0%) had mitral annulus calcification
(MAC), while 104 pts (9.5%) had dilated cardiomyopathy and 58 pts (4.8%)
had coronary disease. AF was permanent from the beggining in 210 pts (19.1%).
Treatment of AF was in concordance with current recommendations, aiming to
control rhythm wherever possible, with 629 pts (57.2%) receiving beta blockers
at some point of the follow up, 656 pts (59.6%) treated with amiodarone, 524 pts
(47.6%) using digoxin at some point of the study, 841 pts (76.5%) received aspirin
for the different time lenght and 677 pts (61.5%) were antikoagulated either
continuously or periodically. We have also administered verapamil to total of 641
pts (58.3%), propafenon to 333 pts (30.3%), sotalol to 82 pts (7.5%) or various
drug combinations to total of 591 pts (53.7%) during the study.
During total follow up of 9.9±12.1 years (prospective 5.7±4.3), 297 pts (27.0%)
developed new cardiac disease and 112 pts (10.2%) noncardiac disorders. Hear
failure was evident in 155 pts (14.1%), 64 pts (5.8%) developed coronary disease
and thromboembolic events occured in 88 pts (8.0%). Total of 531 pts (48.3%) had
permanent AF until the end of the study. There were 85 deaths (7.7%) and 62 of
them (5.6%) were cardiovascular, including 25 sudden cardiac deaths. Mean age
of pts at time of death was 68.0±10.9 years and 10.7±6.6 years elapsed from first
episode of AF. In the time of death 18 pts (21.2%) were in sinus rhythm. Cumulative
5-year survival rate in our study group was 98.1% (95%CI, 97.3-98.9%) and
Cox proportional hazard regression model identified age at diagnosis of AF (HR
1.8, 95%CI 1.4-2.5), reduction of LVEF during follow up (HR 2.0, 95%CI 1.1-3.5),
heart failure during follow up (HR 2.7, 95% CI 1.5-4.6), thromboembolic events
(HR 1.8, 95%CI 1.0-3.3) and MAC (HR 3.8, 95%CI 1.5-9.6) as risk predictors of
all-cause death in patients with AF, while lone AF, use of beta blockers and use
of aspirin had protective impact on mortality (HR 0.2, 95% CI 0.1-0.5, HR 0.5,
95%CI 0.3-0.9 and HR 0.4, 95%CI 0.3-0.5, respectively), adjusted for sex, age
and initial differences among pts with paroxysmal, persistent and permanent AF.
The type of AF at the beggining and during the follow up had no independent,
significant relation to death in our study population.
P1922 Inflammation in lone atrial fibrillation: new insights by
coronary sinus thermography
E. Tsiamis1 , K. Toutouzas2 , M. Drakopoulou1 ,P.Dilaveris1 ,
K. Gatzoulis1 , J. Karabelas1 , S. Vaina1 , E. Stefanadi1 ,K.Vlassis1 ,
C. Stefanadis1 . 1Hippokration Hospital, Athens, Greece;
2Hippokration Hospital, First Department of Cardiology, Athens, Greece
Background: In the clinical setting there are conflicting results regarding the role
of inflammatory activation in atrial fibrillation (AF). Coronary sinus (CS) thermography
assesses myocardial heat production and is correlated with inflammatory
states. We investigated in patients with AF whether 1) there is increased CS blood
temperature and 2) the correlation of heat production with systemic inflammation.
Methods: We included patients with AF and subjects with sinus rhythm. Creactive
protein (CRP) levels were measured in all patients. CS and right atrium
(RA) blood temperature measurements were performed by a dedicated 7F thermography
catheter. �T was calculated by subtracting RA from CS blood temperature.
Results: We included 47 patients with AF and 23 subjects with sinus rhythm. We
stratified patients with AF into two groups: normotensive (AFN) and hypertensive
(AFH). �T was lower in the RA compared with the CS in AFH (37.27±0.52°C vs
37.47±0.54°C, p