Abstract 10931: Impact of Atrial Fibrillation Type (paroxysmal vs. Non-paroxysmal) on Long-Term Clinical Outcomes: The Raffine Registry Subanalysis

Abstract

Background: Type of atrial fibrillation (AF) (paroxysmal or non-paroxysmal) is important for determining the therapeutic management. However, prognostic impact of AF type on incidence of cardiovascular events remains uncertain. Methods: We investigated patients with AF who were selected from an observational, multicenter, prospective registry (RAFFINE) comprising 4 university hospitals and 50 general hospital / clinics in Japan between 2013 and 2015. In this subanalysis of the RAFFINE trial, patients were divided into 2 groups according to their AF pattern at the time of enrollment. The primary outcome was composite of all-cause death, ischemic stroke, and heart failure related hospitalization. Results: Among 3,845 patients, 1,472 (38.3%) and 2,373 (61.7%) were paroxysmal and non-paroxysmal AF, respectively. Patients with non-paroxysmal AF were older, higher CHADS 2 score and had higher prevalence of comorbidities compared with those with paroxysmal AF. During a median follow-up of 3.7 years, 681 (17.7%) primary endpoints were identified. Cumulative incidences of primary endpoint were significantly higher in non-paroxysmal AF group (log-rank p<0.0001, Figure ), however, rates of bleeding events were not significantly different between groups. Multivariate cox hazard analysis showed that non-paroxysmal AF had significantly higher risk of cardiovascular events compared with paroxysmal AF (adjusted hazard ratio: 1.38, 95% confidence interval 1.17-1.64, p = 0.0002). Conclusions: In the RAFFINE registry, non-paroxysmal AF was significantly associated with worse clinical outcomes among AF patients. Long-term clinical outcomes might be improved if the transition paroxysmal to non-paroxysmal AF can be prevented.