Changes in Maximum Daily Atrial Fibrillation Duration Linked With Poor Outcomes in Patients With Cardiac Implantable Electronic Devices

A new study shows that progression from low burden atrial fibrillation (AF) is associated with negative outcomes. The findings were presented at AHA 2024.

The researchers of this study sought to analyze the link between changes in maximum daily AF duration (MDAFD) and the combined study end point of ischemic stroke and mortality among patients with cardiac implantable electronic devices (CIEDs) capable of continuous AF detection. The study consisted of 26,400 CIED patients with health care activity recorded in the EHR >12 months pre- and >6 months post-CIED implant.

The researchers observed in all patients, an increased MDAFD was linked with a higher adjusted rate of stroke and mortality (HR 1.80 [1.61-2.01]). They noted that there was no association between decreased MDAFD in follow-up and the combined end point. The findings of subgroup analysis showed that increased MDAFD during follow up was associated with a greater risk of stroke or mortality among patients with no AF at baseline, and decreased MDAFD in follow-up was associated with a lower adjusted risk of stroke or mortality.

“Results from the present study suggest that progression from low burden AF is associated with negative outcomes, and that there may be threshold effects of baseline AF duration that benefit from enhanced rhythm control. These data encourage continued monitoring of AF duration over time to enhance risk stratification and further inform treatment efforts,” the researchers concluded.

Reference

Peigh, G, Koehler J, Majumder S, et al. Associations Between Changes in Maximum Daily Atrial Fibrillation Duration, Ischemic Stroke and Mortality among Patients with Cardiac Implantable Electronic Devices. Abstract #Su2103. Presented at the American Heart Association Scientific Sessions 2024; November 16-18, Chicago, Illinois.