Abstract 12980: Impaired Left Atrial Function is Associated With Increased Rehospitalisation in Patients With Non-valvular Atrial Fibrillation

Abstract

Introduction: Atrial fibrillation (AF) is the most common arrhythmia encountered in clinical practice with a high clinical and economic burden, largely driven through hospital admissions. Left atrial (LA) size and function have been shown to be powerful predictors of cardiovascular disease. We evaluated the relationship between LA function and AF rehospitalisation. Hypothesis: Impaired LA is a predictor of AF rehospitalisation. Methods: Consecutive patients admitted to a tertiary referral centre (Jan 2013 - Dec 2017) with a diagnosis of non-valvular AF and who underwent transthoracic echocardiogram during their index admission were evaluated for the primary study outcome of AF rehospitalisation. Results: Of the 665 patients (68±14 years, 52% men), 72.2% had paroxysmal AF, 23.4% had persistent AF and 4.4% had permanent AF. The cohort had high cardiovascular comorbidities (33% IHD, 29% HF and 10% previous stroke/TIA). Over a follow-up period of 33 ± 21 months, 253 (38%) patients were rehospitalised for AF. Impaired eGFR (p=0.03), persistent/permanent AF (p=0.05) and indices of LA size and function [see Kaplan Meier curves; LA volume index (LAVI), p<0.01; LA emptying fraction (LAEF), p=0.01; LA expansion index (LAEI), p=0.02; LA function index (LAFI), p<0.01] predicted AF rehospitalisation. Parameters of left ventricular size and function were not predictive of the primary outcome. Multivariable Cox regression models revealed that LAEF (HR 1.58, 95%CI 1.06 to 2.35, p<0.01), LAFI (HR 2.02, 95%CI 1.34 to 3.04, p<0.01) and LAEI (HR 1.58, 95%CI 1.06 to 2.34, p=0.03) were independent predictors of AF rehospitalisation. Conclusions: Impaired LA function is a predictor of AF rehospitalisation.