Chest
Original ResearchCardiovascular DiseaseA 12-Year Follow-up Study of Patients With Newly Diagnosed Lone Atrial Fibrillation: Implications of Arrhythmia Progression on Prognosis: The Belgrade Atrial Fibrillation Study
Section snippets
Materials and Methods
We conducted an observational, longitudinal cohort study of patients with newly diagnosed lone AF in the Belgrade Atrial Fibrillation Study, which was a prospectively completed registry of patients with AF seen in the Clinical Center of Serbia between 1992 and 2007. This is the main cardiology center for specialist arrhythmia services serving the population of Belgrade. All patients gave informed consent. The study complies with the Declaration of Helsinki. The institutional review board stated
Results
Of 1,086 patients with newly diagnosed AF, 346 (31.9%) met inclusion criteria for lone AF. Table 1 shows baseline characteristics and differences among clinical types of AF. Mean total follow-up was 12.1 ± 7.3 years (median, 10.0 years; range, 5–40 years). Mean prospective follow-up was 6.3 ± 4.6 years (median, 5 years; range, 1–16 years). Approximately one-third of patients developed cardiovascular risk factors during follow-up, most frequently hypertension (25%). The rate of development of
Discussion
To our knowledge, the present study examines one of the largest prospective cohorts of newly diagnosed lone AF. After a median 10-year follow-up, our results confirm previous findings of a generally favorable long-term prognosis of lone AF in terms of mortality, thromboembolism, and CHF, with a similar rate of progression to permanent AF as in other lone AF studies.5, 10, 11, 12, 13, 17 Moreover, the present study has documented significant negative implications of progression to permanent AF
Conclusions
The present study provides convincing evidence of a generally favorable prognosis of patients with lone AF. However, long-term outcome in such patients is significantly influenced by aging and the development of underlying heart disease. Because there is no cure for aging per se, thorough screening, prevention, and treatment of associated comorbidities should be among the most important issues in the management of patients with lone AF. Moreover, progression to permanent AF despite active
Acknowledgments
Author contributions: Dr Potpara had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis.
Dr Potpara: contributed to the hypothesis, data collection and analyses, data interpretation, and drafting of the manuscript.
Dr Stankovic: contributed to the data interpretation and drafting of the manuscript.
Dr Beleslin: contributed to the data interpretation and drafting of the manuscript.
Dr Polovina: contributed to the
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Funding/Support: The authors have reported to CHEST that no funding was received for this study.
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