Clinical characteristics of patients with long-term episodes of persistent atrial fibrillation

Abstract

The aim – to compare clinical, instrumental and laboratory characteristics of persistent atrial fibrillation (AF) patients with the duration of AF episode < 90 and ≥ 90 days.Materials and methods. The cross-sectional study consecutively enrolled and analyzed clinical, instrumental and laboratory data from 118 persistent AF patients with the duration of its episode more than 7 days, who underwent an electrical cardioversion. Patients were subdivided into groups with the duration of AF episode 8-89 days (n=58) and ≥ 90 days (n=60).Results and discussion. We observed a significant difference between the studied groups by the frequency of systolic dysfunction cases: 2 (3.5 %) vs. 12 (20.3 %) patients in AF episode duration < 90 and ≥ 90 days groups, respectively (p=0.008). According to transesophageal echocardiography data, we revealed the difference between the groups of comparison by the value of left atrial appendage flow velocity (43.5 cm/s vs. 37.0 cm/s, respectively; p=0.020). The difference between the studied groups by left atrial volume index did not reach the statistical significance (98 (80–110) vs. 99 (86–114) ml/m2, respectively; p=0.088). Besides, both studied groups were characterized by the prevalence of patients with moderate decrease of estimated glomerular filtration rate (eGFR) (60–89 mL/(min·1.73 m2)): 36 (62.1 %) cases in AF episode duration < 90 days, and 38 (63.3 %) – amongst patients with the duration ≥ 90 days. Furthermore, about one-third of patients in both studied groups presented with more pronounced eGFR decline (< 60 mL/(min·1.73 m2)): 16 (27.6 %) and 18 (30.0 %) cases in the groups with AF episode duration < 90 and ≥ 90 days, respectively.Conclusions. The groups of persistent AF patients with the AF episode duration < 90 and ≥ 90 days were comparable by the majority of clinical, instrumental and laboratory characteristics, including the severity of kidney dysfunction. The AF episode duration ≥ 90 days was associated with the higher frequency of left ventricular systolic dysfunction cases, as well as with worse left atrial appendage function