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Incidence and prognostic significance of new onset atrial fibrillation/flutter in acute pericarditis.
Heart ; 101(18): 1463-7, 2015 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-25926597
ABSTRACT

OBJECTIVE:

Data on the incidence of new onset atrial fibrillation and flutter (AF/f) in patients with acute pericarditis are limited. We sought to determine the incidence and prognostic significance of AF/f in this setting.

METHODS:

Between January 2006 and June 2014, consecutive new cases of acute pericarditis were included in two urban referral centres for pericardial diseases. All new cases of AF/f defined as episodes lasting ≥30 s were recorded. Events considered during follow-up consisted of AF/f and pericarditis recurrence, cardiac tamponade, pericardial constriction and death.

RESULTS:

822 consecutive new cases of acute pericarditis (mean age 53±15 years, 444 men) were analysed. AF/f was detected in 35 patients (4.3%, mean age 66.5±11.3 years, 18 men). Patients with AF/f were significantly older (p=0.017) and presented more frequently with pericardial effusion (p<0.001). Arrhythmias developed within 24 h of pericarditis onset in 91.4% of cases, lasted >24 h in 25.7% and spontaneously converted in 74.3% of patients. Underlying structural heart disease was present in 17% of AF/f cases. In a 30-month follow-up, patients with history of AF/f at the initial episode had a higher rate of arrhythmia occurrence (34.3% vs 0.9%, p<0.001), mostly (75%) within 3 months. No other differences were detected in additional clinical events including haemorrhagic complications in patients receiving oral anticoagulation.

CONCLUSIONS:

The occurrence of AF/f in acute pericarditis identifies a predisposed population to AF/f with a high recurrence risk (about 35%) in these patients, pericarditis may act as an arrhythmic trigger and oral anticoagulation should be seriously considered according to guidelines.
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Texto completo: Disponível Coleções: Bases de dados internacionais Base de dados: MEDLINE Assunto principal: Pericardite / Fibrilação Atrial / Anticoagulantes Aspecto clínico: Etiologia / Prognóstico Limite: Idoso / Feminino / Humanos / Masculino / Meia-Idade País/Região como assunto: Europa Idioma: Inglês Revista: Heart Assunto da revista: Cardiologia Ano de publicação: 2015 Tipo de documento: Artigo País de afiliação: Itália