1
|
Mason PK, Desai A, Ajijola OA, Amin AK, Barbhaiya C, Basil A, DeBiasi R, Dukes J, Fradley M, Ismail H, Jackson L, Mendelson T, Montgomery J, Orencole MP, Syed FF, Wan E, Zilinski J, Singh JP. Integrated electrophysiology care for patients with heart failure: An envisioned future. Heart Rhythm 2021; 18:e51-e63. [PMID: 33065255 DOI: 10.1016/j.hrthm.2020.10.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Accepted: 10/09/2020] [Indexed: 11/15/2022]
Affiliation(s)
| | - Akshay Desai
- Brigham and Women's Hospital, Boston, Massachusetts
| | | | - Anish K Amin
- Riverside Methodist Hospital, Upper Arlington, Ohio
| | | | - Anuj Basil
- Temple University, Philadelphia, Pennsylvania
| | - Ralph DeBiasi
- Yale University School of Medicine, New Haven, Connecticut
| | | | | | | | - Larry Jackson
- Duke University Medical Center, Durham, North Carolina
| | - Todd Mendelson
- Pennsylvania Presbyterian Medical Center, Philadelphia, Pennsylvania
| | - Jay Montgomery
- Vanderbilt University Medical Center, Nashville, Tennessee
| | | | - Faisal F Syed
- University of North Carolina, Chapel Hill, North Carolina
| | | | | | | |
Collapse
|
2
|
Chawla D, Olet S, Mortada ME, Zilinski J, Ammar KA, Nangia V, Bhatia A, Niazi I, Sra J, Tajik AJ, Jahangir A. P5658Incorporation of severity of left atrial enlargement in clinical risk factors improves identification of patients at risk for development of atrial fibrillation. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz746.0601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Early identification of patients at risk for atrial fibrillation (AF) is desirable to prevent its development and complications. Clinical predictors have been recognized but need refinement to improve predictability. We evaluated whether severity of left atrial enlargement (LAE) added to a scoring system (CHA2DS2VASC) in an unselected non-AF population improves risk stratification for incident AF.
Purpose
To assess the incremental benefit of LAE severity added to CHA2DS2VASc in predicting future AF in non-AF patients.
Methods
From 2012–2017, consecutive adult patients with an echocardiogram and no prior AF were identified. CHA2DS2VASc was used to define baseline AF risk, and the incremental risk of AF with addition of LAE was assessed through increased LA volume index (LAVI; moderate 42–48 ml/m2, severe >48 ml/m2). To quantify improvement in risk prediction, logistic regression model was fitted and odds ratios (OR) and ROC curves obtained.
Results
Out of 155,597 patients with no prior AF, 13.8% developed AF over 1.5±1.3 years. OR for AF with CHA2DS2VASc was 1.68 (95% CI 1.66–1.69). With addition of moderately or severely increased LAVI to the model, OR for AF increased to 2.3 (2.2–2.5) and 3.8 (3.6–4.0), respectively. ROC analysis showed c-statistics of 0.66 with CHA2DS2VASc, 0.63 with LAVI, and 0.71 with incorporation of both (Fig).
AF CHAD score
Conclusion(s)
In non-AF patients, predictability for future AF can be improved by using clinical factors (CHA2DS2VASc) and increased LAVI. This information may guide closer monitoring and initiation of therapies to prevent progression to AF or stroke.
Acknowledgement/Funding
None
Collapse
Affiliation(s)
- D Chawla
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - S Olet
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - M E Mortada
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - J Zilinski
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - K A Ammar
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - V Nangia
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A Bhatia
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - I Niazi
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - J Sra
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A J Tajik
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| | - A Jahangir
- Aurora Sinai Aurora St. Luke's Medical Centers, Milwaukee, United States of America
| |
Collapse
|